Please download and fill out the following forms prior to your first appointment with your provider (except for the FMPA Minor Confidentiality Form, which is only required by parents of individuals who are younger than 18 years old, and the Release of Confidential Information Form is only required if you would like your provider to communicate with someone such as your primary care doctor or a family member).   Your provider will go over the forms with you at your first appointment. 

Adults

New Patient Information Form Consent Agreement to pay HIPAA Notice Adult Screening Questionnaires Adverse Childhood Experience

 

Additional Forms

Release of Confidential Information Credit Card Authorization Telepsychology Consent Yale Brown OCD Scale

Adolescent Forms

FMPA Minor Confidentiality Form Adolescent Questionnaire Adverse Childhood Experience