Intake forms

All clients will need to complete the following two forms:

Office agreement: Print name, sign, and date.

Credit Card info: If you have insurance with a high-deductible plan, insurance with co-pay, or are a Private Pay client and wish to pay with credit card, please complete the credit card information [Venmo and PayPal also accepted].

New Client form:  Complete all information. If you feel like only highlighting with main bullet points that is fine.  Providing more detail allows the first session to be more open. 

NOTE: FORMS ARE PRIVATE AND SECURE VIA WIX HIPAA PROTOCOL USING HIPAATIZER FORMS. 

Instructions: You can start with office agreement, scroll down, then sign and click Continue at bottom. Then you continue on to the New Client form and click continue when finished with that.  You can also go to the two form web. links by clicking on the two URLs.  

Office Agreement - https://hptz.io/0Y6gSkq

New Client form - https://hptz.io/0DY94gG

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