This is an information-gathering intake form designed to cut down time spent in the waiting room completing information. Please be ready to have the following to complete the form:
- Basic information on the person being seen for therapy (age, DOB, address, etc_
- Insurance information, including images of the insurance card
- Individual who is authorized to legally sign for treatment (adult, adult caregiver)
Please complete ALL parts of the intake form. This will allow for a smoother intake process and less forms to sign.