Intake Forms
Forms needed for your initial appointment are linked below for your convenience. Please feel free to complete and sign the forms & bring them with you to your first appointment.
Personal Information/Intake Form
Service Agreement
HIPPA Form
Payment Agreement Form
Payment Agreement Form - Couples
Permission to Treat Minors
Convenient and Confidential Online Scheduling
Click above to schedule your appointment today.
Toll free:
(866)753-1682
Memberships: APAOPAACEP
