Other Forms

Whether you are a current or new current client, we would like you to complete the forms below and bring them to your next appointment.  They include the Credit Card Authorization form, the Electronic Communication Consent form, and the Contact Consent form.  You may review the below and print them individually by clicking on their titles, or you may click here to print a complete packet, including the Client Services Agreement.

Credit Card Authorization Form

The Credit Card Authorization form gives us permission to charge your credit card in case of missed appointments, additional services, or when you authorize it as your prepay method.

Electronic Communication Consent Form

The Electronic Communication Consent Form acknowledges that you understand the risks and limitations of communicating via email or Skype.

Contact Consent Form

The Contact Consent Form authorizes us to discuss your medical information with the people you may designate.  You may choose not to designate anyone, or you may print multiple copies of this form to designate more people.  An common designation might be a parent when the client is a college student who is still under a parent's care but is over 18 years old.