Please read and complete every section thoroughly before you submit. You will be asked several times to type your full legal name as acknowledgement of your signature for submission. After you complete the intake forms, a copy of your responses will be sent to the email address you provide below for your records.
By providing your email address and completing this paperwork online, you are consenting to receive information, including completed forms and documents, via email. Although this is a common practice and handled through a secure electronic system, email is not always encrypted. If you prefer not to receive documents by email, please let us know before completing the intake paperwork or choose not to provide an email address. You are not required to accept documents by email to participate in therapy.
Please allow for at least 20 minutes to complete the new patient paperwork and forms. Because of the length of the form, please scroll down within the form to complete all information in each section. You will see the "Next" button at the end of each section. Once the next page loads, you may need to scroll to the top of the form.
If you do not feel comfortable answering any question at any time during the intake paperwork process, please do not answer and simply write N/A.