Forms

Please fill out Client Info, Consent Form, Health History and any Child Forms and Return ~ Thank you.

Client Information

Please send these back at least 24 hours before your appointment.

I'm aware that the amount of information requested is quite extensive. Please do not let it overwhelm or deter you, simply respond as best as possible and focus on what you consider the most relevant information pertaining to you.

Consent Form

This form must be received prior to your appointment. Please be sure it is sent.

Health History

This is a long form but necessary... please fill out as much as possible. Thank you.

Child Intake Form

Pediatric form ~ Fill this form IN ADDITION TO the health form, for children.

Autism Form

If you have a child with autism or on the spectrum please also include this online fillable form. If you have trouble clicking on the fields or saving - scan or snap a pic and email back.

NOTE: TIPS TO DOWNLOAD THE FORM SUCCESSFULLY:
- Click the needed ‘ Form’ to download,
- After it downloads and BEFORE beginning to fill it out, SAVE the form to your desktop or any other location of your choice,
- They are in a FILLABLE pdf format for your convenience,
- You may need the Free Adobe Reader for Phone or for Your PC.
- To view by phone- you may need to Click "Send To" and "Export to Adobe"
- Fill out the form and SAVE again,
- Then return it as an email attachment.
- Totally fine if it's easier to Print, scan and email back.
- NEXT - be sure to review the ZOOM Telehealth page.