Downloadable Forms (PDF)

Initial Intake Forms (Please Print all Three Forms)

Intake Form

Request for Treatment and Authorization to Communicate with PCP

Statement of Policies and Proceedures and Patient Rights

Or download the all forms in zipped archive

Intake forms in zip format

MEDICAID ONLY Initial Intake Forms (Please Print all Three Forms)

Intake Form – Medicaid

Request for Treatment and Authorization to Communicate with PCP – Medicaid

Statement of Policies and Proceedures and Patient Rights – Medicaid

Or download the all forms in zipped archive

Intake forms in zip format – Medicaid

Additional Forms

Child History Form

Consent to Release Information

Coronavirus Forms