INTAKE FORMS
Notice of Privacy Practices for Protected Health Information
Notice of Privacy Practices Receipt and Acknowledgment of Notice
Informed Consent for Treatment
Informed Consent for Telepsychology
Outpatient Services Contract
Authorization Form to Obtain/Release of Information
Basic Information Form
We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website.This form is for general questions or messages to the practitioner.
Office Hours
MONDAY: | 9:00 am-9:00 pm |
TUESDAY: | 9:00 am-9:00 pm |
WEDNESDAY: | 9:00 am-9:00 pm |
THURSDAY: | 9:00 am-9:00 pm |
FRIDAY: | 9:00 am-9:00 pm |
SATURDAY: | 9:00 am-5:00 pm |
SUNDAY: | 9:00 am-2:00 pm |