We are looking forward to meeting you at our office in Weston! All forms below are in PDF format. Please print the appropriate forms below for your first visit. If you have questions or need assistance call (954) 385-6750.
REQUIRED FORMS ON YOUR FIRST APPOINTMENT:
- Welcome Letter (For viewing only)
Patient Information & Consent Form
Psychological Services Agreement & Policies Form
- HIPAA Privacy Notice (For viewing only)
HIPAA Signature Form
IF YOU WILL BE USING INSURANCE:
Insurance Consent Form
– Please bring insurance card and driver’s license/ID with you to initial visit
HISTORY FORMS:
Adult History Form (individual therapy)
Child and Adolescent Form (for parents to complete)
Adult Testing History Form (for testing services only)
Child and Adolescent Testing Form (for testing services only)
Couples History Form (for couples therapy)
COORDINATION OF CARE (consent to communicate with others):