Forms

Please fill out the following forms online, print them, and bring them to your first appointment. For your privacy, the most secure way of submitting forms to your therapist is in person or through the US Postal Service. If you choose to email a form, please be aware that email is not a secure platform. 

Office Practices During COVID-19
Teletherapy Consent Form

Adults- 

Personal Information Form
HIPAA Informed Consent Form
Credit Card Authorizations Form
Notice of Mental Health Privacy Practices
Release of Information Form

Per request of your therapist:

DBT Individual Client Informed Consent
Adult Skills Group Agreements
Skills Coaching Contract

Adolescents  and Families-

Personal Information Form
Teen Assessment Form
HIPAA Informed Consent Form
Credit Card Authorizations Form
Notice of Mental Health Privacy Practices
Release of Information Form

Per request from your therapist:

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