Forms

Adults – Please fill out the following forms online, print them, and bring them to your first appointment:
Personal Information Form
HIPAA and Authorizations Form
Notice of Mental Health Privacy Practices
Release of Information Form

Adults – At your therapist’s request, please fill out the following forms online, print them, and bring them to your appointment:
DBT Individual Client Informed Consent
Adult Skills Group Agreements
Skills Coaching Contract

Adolescents – Please fill out the following forms online, print them, and bring them with you to your first appointment:
Personal Information Form
Teen Assessment Form
HIPAA and Authorizations Form
Notice of Mental Health Privacy Practices
Release of Information Form

Adolescents – At your therapist’s request, please fill out the following forms online, print them, and bring them to your appointment:
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