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Online Forms
Client Information Form:
• Client Information
HIPAA Notice Form:
• HIPAA Notice of Privacy Practice
HIPAA Receipt Form:
• Receipt of HIPAA
Client Release Form:
• Client Release of Information
Online Forms: Michelle Mazza,
Pam Jacobson, Katie LeRoy
Client Policies Form:
• Client Information Policies
Consent for Treatment Form:
• Consent for Treatment
Client Intake Form:
• Client Intake
Consent to Release Form:
• Client Consent to Release Information
Online Forms: Beatrice Chorinsky
The following forms are the paperwork needed for your first appointment. Please download each form, fill out completely and bring it to your first appointment. The release of information form should be completed for past and current treatment providers.