New Client Forms

Each new client should do the following prior to your first visit:
The computer you are using must have either Microsoft Word (97 or newer) or Adobe Acrobat Reader (4.0 or newer).
NOTE: If you have Microsoft Word, please fill out most of the forms on the computer first and then print and sign as needed. This is the preferred method. If you have Adobe Acrobat Reader then you must print the forms first and then fill them out with a pen.
Please do not email forms to maintain privacy. Bring to your next session.

Please complete All in one (Microsoft Word) OR All in one (Acrobat)

  1. Understand the Fee Policy
  2. Print and fill out the Registration Form.
  3. Print, read and sign the Privacy Policy.
  4. Print, read and sign the Hippa policy.
  5. Print, read and sign Consent pages.
  6. Bring all pages in on your first visit.


Magellan Clients:
Statement of Understanding
Client Information Form

United Behavioral Health Life Era EAP Clients:
Statement of Understanding
Initial Wellness Assessment (Adults)

Value Options:
Statement of Understanding
Outpatient Registration Form


If you have any questions regarding the above forms or experience any difficulty downloading, please contact Sharon for assistance.