Downloadable Forms

 

For Child Assessment:

1.  Appointment Letter

2.  Child History Form – Print, complete, and bring with you to the appointment

3.  Map

4.  Privacy Notice

5.  Good Faith Estimate Notice

 

For Adult Assessment:

1.  Appointment Letter

2.  Adult History Form – Print, complete, and bring with you to the appointment

3.  Map

4.  Privacy Notice

5.  Good Faith Estimate Notice

 

For Adult Therapy:

1.  Treatment Services Contract – Print, sign, and bring with you to the appointment

2.  Adult History Form – Print, complete, and bring with you to the appointment

3.  Map

4.  Privacy Notice

5.  Good Faith Estimate Notice

 

For Referring Agency:

1.  Referral Form

2.  Release of Information

3.  Brochure for Neuropsychological Evaluations (Dr. Jennifer Huffman)