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Helpful Forms

If you are a new client, you may download and complete these forms in BLACK INK and bring them with you to your first therapy session.  Or, you can wait until your first session, and complete them in our office. If you are doing teletherapy with a therapist and will not be coming to the office, please download the forms and email them to us at [email protected] You can also mail the forms to our office in Newark. 


Client Information Form  
Statement of Understanding  
Notice of Privacy Practices  
Health Insurance Claim Form  
Receipt of Privacy Notice  
Consent to Treatment  
Teleheath Consent  
COVID-19 Informed Consent to Treat  


Note: To download Adobe Acrobat Reader for free, click here.

Health Insurance Claim Form

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Helpful Forms

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