Forms

The following forms are for you to use to learn about my office policies and to fill out prior to your first visit. The last page of each form needs to be signed, and brought to your initial appointment or submitted online.

Adult Intake Form You will fill this out to bring to our first meeting. It provides basic information that I need for contacting you and for record-keeping.

HIPPA Form I am required to give you this form when you come to my practice. It outlines information about confidentiality and the sharing of confidential information among health care professionals. The last page needs to be printed out, signed, and brought to your initial appointment.

Covid Protocols Form This must be filled out before coming into the office. You may attach it to an email and mail it to both me and Alice, my assistant, or bring a hard copy to me.

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