Telehealth
Consent Form

Child Paperwork
for Initial Session

Adolescent Paperwork
for Initial Session

Adult Paperwork
for Initial Session

Child Social Security Determination Paperwork

Adult Social Security Determination Paperwork

Child Paperwork for Initial Session

Patient Rights and Responsibilities Statement

Communication Authorization

Patient Information

Parent's Questionnaire for Child - Part 1

Parent's Questionnaire for Child - Part 2

Notice of Privacy Practices

Adolescent Paperwork for Initial Session

Patient Rights and Responsibilities Statement

Communication Authorization

Patient Information

Parent's Questionnaire for Adolescent - Part 1

Parent's Questionnaire for Adolescent - Part 2

Alcohol / Drug History

Notice of Privacy Practices

Adult Paperwork for Initial Session

Patient Rights and Responsibilities Statement

Communication Authorization

Patient Information

Adult Patient Information - Part 1

Adult Patient Information - Part 2

Alcohol / Drug History

Notice of Privacy Practices

Child Social Security Determination Paperwork

Patient Rights and Responsibilities Statement

Patient Information

Parent's Questionnaire for Child Assessment

Notice of Privacy Practices

Adult Social Security Determination Paperwork

Patient Rights and Responsibilities Statement

Patient Information

Adult Social Security Assessment

Alcohol / Drug History

Notice of Privacy Practices