To facilitate a seamless and efficient process, we kindly ask you to complete the following forms online, print them out, and bring them to your initial appointment. To ensure the utmost privacy and security of your information, we highly recommend submitting forms in person or via the reliable US Postal Service. If you find it more convenient to email a form, please be aware that email is not a secure platform for transmitting sensitive information.
 

COVID-19 Office Practices
Teletherapy Consent Form
 

For Adults:

• Personal Information Form

• HIPAA Informed Consent Form

• Credit Card Authorization Form

• Notice of Mental Health Privacy Practices

• Release of Information Form
   

Upon your therapist's request:

• DBT Individual Client Informed Consent

• Adult Skills Group Agreements

• Skills Coaching Contract
   

For Adolescents and Families:

• Personal Information Form

• Teen Assessment Form

• HIPAA Informed Consent Form

• Credit Card Authorization Form

• Notice of Mental Health Privacy Practices

• Release of Information Form
   

Upon your therapist's request:

• DBT Individual Client Informed Consent

• MultiFamily Skills Group Agreements

• Skills Coaching Contract
   

Diary Cards:

• Adult Diary Card Version A

• Adult Diary Card Version B

• Adult Diary Card Version C

• MultiFamily Diary Card
   

Thank you for your cooperation. These forms are essential for us to provide you with the best possible care. If you have any questions or concerns, please don't hesitate to contact us.