Several of our office forms are available below so you can complete them prior to your initial appointment.

New/Current Client Paperwork:

• New Client Information Paperwork

Download this fillable PDF if you are a new client starting therapy at our practice. Please return your completed paperwork to our office before your first appointment.

• Credit Card Authorization Form

For your convenience and office efficiency, please complete and return this Credit Card Authorization Form to charge your card for payments at the time of service. Your credit card information is secure.

• Telehealth/Video Therapy Consent Form

If you are utilizing telehealth for any part of your therapy services, please review our related policies and return the completed form to our office prior to your first telehealth session.

• Release of Information

In order to collaborate with other providers or parties, please complete and return the Release of Information to authorize sharing of your information.

• Privacy Policy

Please read our privacy policy before beginning treatment to review our commitment to your privacy.

• Divorced/Separated/Soon to be Divorced Parent Policy

Review and sign this form if you are seeking services for your child or teen and you are divorced/separated so you are clear on our expectations.

Forms for ADHD Assessment/Screening:

The forms below are often used in screening for ADHD symptoms. If you have concerns about ADHD symptoms, please bring the completed forms with you to your therapy appointment:

• ADHD Assessment NICQH Vanderbilt Parent Rating Form
• ADHD Assessment NICQH Vanderbilt Teacher Rating Form (teachers can fax to 859-781-0123)
• ADHD Assessment Adult Self Rating Scale