Forms

Click on the files to download and complete prior to your first session.

HIPPA Form for you to keep:Notice of Privacy Practices 2018

HIPPA Authorization: HIPPA AUTHORIZATION FORM

Consent for Treatment of Minor: consent for minor

Confirmation of Privacy Form and Informed Consent: aknowledgement of reciept of privacy practices 2018

Insurance and Payment Form: insurance-and-payment-form

Advisement Form: advisment form

Only Complete for your Therapist

Informed Consent for Jayde Young: jaydeinformedconsent

Informed Consent for Ashley Applewhite: Professional Disclosure Statement_Ashley Applewhite

Sliding Scale Form for Ashley Applewhite: Sliding Scale
 
Informed Consent for Adrienne Marshall:Adrienne Dimas Disclosure and Informed Consent

Sliding Scale Form for Adrienne Marshall: Sliding Scale