Forms and Patient Portal Access
Access your Patient Portal
The patient portal can used to submit a medication refill request, pay balances, view upcoming appointments and more!
New Patient Intake Form
Please fill out this form if you would like to become a new patient with us.
*We do not accept any Medicaid policies. If you have Aetna, Cigna, United Healthcare, or other commercial plans we could see you for a self-pay rate*
Psychotherapy Informed Consent
Therapy-Only New Client Paperwork
Sliding Scale Fee Application
HIPPA Forms
Permission To Release Info
Patient Policies
Medication Refill Request
In order to submit a medication refill request you will need to do so through your patient portal. If you do not have a patient portal, please call or text our office. One of our representatives will help you get your patient portal set up and direct you on what you will need to do.
Administrative Forms
HIPPA Forms
Permission to Release Info
Electronic Medical Release Records
Statement of Charges
Patient Policies