ESTADT PSYCHOLOGICAL SERVICES

DR. ESTADT AND HIS STAFF SUPPORT PSYCHOTHERAPY FOR A FUTURE WORTH CELEBRATING

New Patient Intakes
267-559-0471
267-304-3414

INTAKE FORMS

Notice of Privacy Practices for Protected Health Information

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Notice of Privacy Practices Receipt and Acknowledgment of Notice

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Informed Consent for Treatment

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Outpatient Services Contract

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Authorization Form to Obtain/Release of Information

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Basic Information Form

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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