Patient Forms

Click the link below to view and to download the 'Patient Forms' that will be needed for intake purposes.

Click for 'Intake Patient Forms' / PDFs

To fill out the Patient Forms electronically, please use the links below.

These forms are encrypted to insure your confidentiality.

1. Welcome

2. Personal Inventory

3. Agreement to Treat

4. Information for Patient Billing

5. Medication Checklist

6. Summary Notice of Privacy Practice

7. Quick Inventory of Depressive Symptoms

8. Counseling Outcomes

9. Spiritual Index of Well-being