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
Rights and Protections Against Surprise Medical Bills.
Good Faith Estimate

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Health Insurance Claim Form

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