Forms

Prior to your initial consultation, please fill out the following forms beforehand. The forms are grouped into Required and Optional. Please note that the forms are in PDF format and may open in a new tab or window, depending on the browser you are using. All information will be kept strictly confidential.

If you do not have the Adobe Reader, you can download a free copy here.

 

Required Forms

Client Demographic Form

Client Rights and Responsibility

Acknowledgement of Notice of Privacy Practices

Service Fee Form

Optional Forms

Client Appeals

Notice of Confidentiality of Alcohol and Drug Abuse Client Records

Release to Primary Care Physician

Release of Information