Patient forms

Fill out and sign each form right on your phone — no printer needed. You can still open, download, or upload a paper copy if you prefer.

• Informed Consent for Behavioral & Mental Health Care

  Your consent to begin treatment, including telehealth visits.

  Fill out Open DownloadUpload
• Notice of Privacy Practices

  How your health information is used, protected, and shared.

  Fill out Open DownloadUpload
• Patient Rights & Responsibilities

  What you can expect from us, and what we ask of you.

  Fill out Open DownloadUpload
• Appointment & Cancellation Policy

  Scheduling, rescheduling, late arrivals, and no-show terms.

  Fill out Open DownloadUpload
• Medical Record Release Authorization (HIPAA)

  Authorize us to request or share your medical records.

  Fill out Open DownloadUpload
• Psychotherapy Notes Release (HIPAA)

  Separate authorization required for psychotherapy notes.

  Fill out Open DownloadUpload
• Authorization & Consent for AI Assistance

  Your choice about AI-assisted tools used during care.

  Fill out Open DownloadUpload
• No Surprises Act Disclosure

  Your protections against unexpected out-of-network bills.

  Fill out Open DownloadUpload
• Grievance Policy

  How to raise a concern and how we resolve it.

  Fill out Open DownloadUpload
• ADHD Self-Report Questionnaire (ASRS v1.1)

  Complete before an ADHD evaluation visit.

  Fill out Open DownloadUpload