• Adults (18+)
  Please fill out all forms below:

  • Terms of Billing
  • No Show & Cancellation Policy
  • Clinical Intake Form
  • Insurance Card Form
  • Driver’s License Form
  • Major Depression (PHQ-9) Scale
  • Cage-Aid Substance Use Screening
  • Generalized Anxiety Disorder 7-Item Scale
  • Patient Bill of Rights
  • HIPAA

• Children (Under 18)
  Please fill out all forms below:

  • Terms of Billing
  • No Show & Cancellation Policy
  • Clinical Intake Form
  • Insurance Card Form
  • Driver’s License Form
  • Major Depression (PHQ-9) Scale
  • Cage-Aid Substance Use Screening
  • Generalized Anxiety Disorder 7-Item Scale
  • Patient Bill of Rights
  • HIPAA

cookAdminINTAKE FORMS09.24.2014