If you're a new client, please complete the following forms and bring them to your first session. If you are a returning client, but it has been more than 2 years, you will need new forms.
Client Information Form (all patients must complete)
HIPAA Notice (all patients must complete)
Credit Card Authorization Form 2023 (all patients must complete)
Consent Form - Adult (select this form if you are 18 years of age or older and services are for yourself)
Consent Form - Child (select this form if you are bringing your child or adolescent for services)
Telementalhealth Consent (select this form if you will be doing any telehealth services)
COVID Consent Form (select this form to consent to in-person services)
If you would like Dr. Lokken, Dr. Woodcox, Dr. Adelson, Courtney, or Nicole to coordinate care with another provider (for example, your psychiatrist, primary care physician, school, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here .