1.Late/No Show and Card Authorization

Please download, complete and bring to your FIRST appointment.

4.Notice of Privacy Practices.

Please download, complete and bring to your FIRST appointment.

WHAT FORMS DO I NEED TO COMPLETE?

FIRST TIME CLIENTS:

 

-ADULTS: Please print forms 1,2 and 4.

-CHILDREN: Please print forms 1,3 and 4.

PROVIDERS AND PROFESSIONALS

- Please print form 5 and mail it in OR complete the "Clinical Referral Form" below.

2.Adult (+18)Intake

Please download, complete and bring to your FIRST appointment.

3.Child (0-17)Intake

Please download, complete and bring to your FIRST appointment.

5.Provider Referral Form.

ONLY FOR PROVIDERS wonting to refer clients.  

QUE FORMULARIOS TENGO QUE COMPLETAR?

En su PRIMERA VISITA si usted es:

 

-ADULTOS:Por favor imprima los formularios 1,2 y 4.

-NINOS: Por favor imprima los formularios 1,3 y 4.

POFESIONALES:

- Por favor imprima el formulario 5 y mandelo a nuestra direccion de corrreo O complete el formulario de abjajo llamado "Clinical Referral Form".

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