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New Client Forms

Please find below the following forms to bring to your first appointment:

  1. Intake form
  2. Symptoms Checklist 90
  3. HIPAA Notice of Privacy Practices
  4. Office Policies and General Information
  5. Professional Disclosure Statement

Please print all 4 of these documents using Adobe Acrobat Reader.

Complete the Intake form and Symptoms checklist, and review and sign the HIPAA Notice of Privacy Practices and Office Policies and General Information documents. The Professional Disclosure Statement is for you to keep.

Bring the first 4 completed and/or signed forms to your first appointment. If you have any questions, please do not hesitate to call 503-740-5742 for more information.

 
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