Forms

The Forms Vault

New Client Request Form

If you are a NEW client wanting to get services and you have not been assigned to a therapist yet, please fill out our therapy request form and a member of our team will get back to you as soon as possible.

New Client Request

Medical Management Request Form

THIS FORM IS FOR FAMILY HEALTH AND PRESCRIPTION MEDICATION REQUESTS ONLY.

Please fill out our request form and a member of our team will get back to you as soon as possible.

Medical Management

Client Registration Form

Already have a therapist and have your appointment scheduled? GREAT! You are in the right place!

IF YOU DO NOT HAVE A THERAPIST ASSIGNED PLEASE CLICK TO GO TO OUR THERAPY REQUEST FORM

Client Registration

Release of Information Form

Need to give us permission to talk to someone about your treatment? This is the form for you!

Release of Information

Payment/Credit Card Update Form

Please fill out this form if you need to update the method of payment we have on file for copays, deductibles, private pays, coinsurances, etc..

Payment Update

Insurance Update Form

Your insurance may change during the course of your treatment. This form lets us know any and all changes you have had to your insurance.

Insurance Update