Forms and Links

For All New Patients:
You may download, print out, and complete all of your registration paperwork and bring it with you to your first appointment.

1.  Read these three documents: (no need to print)
•   Informed Consent for Psychological Services    
•   Financial Policies    
•   North Carolina Privacy Notice Form

2.  Print and complete these two forms:
•   Registration Form    
•   Psychological Services Agreement

3.  Print and complete the form that corresponds to the service you will be receiving:
    (please choose only one)
•   Bariatric Surgery Evaluation Questionnaire               
•   Adult Therapy Questionnaire     
•   Child Therapy Questionnaire

I will be happy to answer any questions you may have about these forms at our initial meeting. Please contact me in advance if you will be unable to complete your registration forms prior to your first appointment. If you will need to complete the forms at my office, please plan to arrive at least 20 minutes early in order to have adequate time. Also, it would be helpful to review the Informed Consent for Psychological Services, Financial Policies, and North Carolina Privacy Notice Form prior to arrival. Please bring your insurance card and payment (cash or check only) with you to your initial appointment.

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