Intake Forms

Please complete the following forms prior to your first session. This helps us provide you with the best possible care.

Intake Form

Basic information and history

HIPPA Authorization

Privacy and consent form

Informed Consent

Understanding your rights

Authorizations

Release of information

Misc. Forms

Additional documentation

Misc. Forms

Additional documentation

Choose How to Sign

Select your preferred method for completing and submitting forms.

Docu Sign

Sign form Electronically online

Simple Practice Login

Access your patient portal

Authorizations

Release of information

Misc. Forms

Additional documentation

Need Assistance Filling Out Forms?

If you need help completing any forms or require accommodations, please don’t hesitate to contact me. I’m here to help (Steven M Brown)

Contact for Assistance