Online Forms

After you have scheduled your first appointment, the below forms can be completed online. Once you click submit, they will be emailed to us directly.

New Clients

Your Release of Information Form will be emailed to the email address that was provided during intake.  This form is attached here for your convenience.

Consent to Treatment

• Tele-Mental Health Consent

• Multiple Persons in Therapy

• Communicating Through E-mail or Text Messaging

DSM 5 – SYMPTOM MEASURES

• DSM 5 –  Self-Rated for 18+

• DSM 5 –  Self-Rated for Adolescents ages 11-17

• DSM 5-   Parent/Guardian Rated for ages 6-17

Additional Forms

• Release of Information (ROI)

• Chart Release Form

• Medication List 

DBT

• Life Worth Living

• DBT Group Evaluation

PDF Forms

• Diary Card

• Advanced Diary Card

• HIPAA – Notice of Privacy Practices