HIPAA-compliant Forms
New Patient Intake Form
New Patient Intake Form
New Patient Intake Form
Intake Form:
Call 877-588-0282 to receive new patient HIPAA-compliant forms. We verify insurance FIRST before providing an appointment to avoid any surprises about insurance coverage.
Practice Policies
New Patient Intake Form
New Patient Intake Form
Office Policies are under revision, but a few are posted on the website.
Have questions? Call the office.
Release of Information
New Patient Intake Form
Release of Information
The Release of Information Form is under revision.
Call the office and request to use the old form.
Resources
NAMI
Suicide Prevention Lifeline
Suicide Prevention Lifeline
National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.
Phone: 1 (800) 950-NAMI (6264)
Suicide Prevention Lifeline
Suicide Prevention Lifeline
Suicide Prevention Lifeline
The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
www.suicidepreventionlifeline.org
Phone: 1 (800) 273-8255 (TALK)
Deaf/HOH: 1 (800) 799-4889
LGBTQ Youth
Suicide Prevention Lifeline
LGBTQ Youth
The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning youth.
Phone: 1 (866) 488-7386
Text START to 678678