Forms

Online Balance Payment

This form will be used to pay your existing balance.

Psychotherapy Telehealth Informed Consent​

Therapy-Only New Client Paperwork

Sliding Scale Fee Application

HIPPA Forms

Permission To Release Info

Patient Policies

Medication Refill Request

When you request a medication refill, your medication will be sent within 24 hours. Your pharmacy should notify you when your medication is ready.

Administrative Forms

HIPPA Forms

Get in contact with a professional at Hagan Health.