The following are important documents that we may ask you to fill out. We can email or physically mail you a copy of the most up-to-date version of these documents upon request.
These documents were last updated on January 3, 2022
- Intake of Basic Information
- Patient Case History (Pediatric)
- Release of Information Form (this allows us to obtain medical and/or school records if needed)
- Privacy Notice
- Consent for Treatment and/or Evaluation
- Clinic Policies
- Screening Permission
- Consent for Photo &/or Video
- SAMPLE Best Estimate of Cost & Out of Network Consent (contact us for a personalized estimate).
