Below are standard forms I use in my practice. They may be printed and filled out by hand, or you may type your information, then print the document.

You will need Adobe Reader to open the files. If you don't have it, you may download it at no cost.

  

THERAPY SERVICES AGREEMENT

This document contains important information about my professional services and business policies. Please read it carefully. When you sign this document, it will represent an agreement between us.
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ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF INFORMATION PRACTICES 

This document acknowledges that you have received the "Therapy Services Agreement" and explains the legal standards for record keeping and access to records in the effort to protect the privacy of your personal health information. 
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RELEASE OF INFORMATION FORM

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ADULT INTAKE FORM

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INTAKE FORM FOR YOUTH

This document not only provides the information necessary to properly bill your insurance company, it asks for additional details that will assist in developing the best therapy services for a patient under the age of 18.
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