New Client Forms
NEW CLIENTS: Please print "Adult Intake Form" and "Informed Consent", fill out and bring with you to your first appointment. If the client is under 18 years old, please print out "Child/Adolescent Intake Form" and "Informed Consent", fill out and bring with you to your child's first appointment. HIPAA is in the list below for your information. You do not need to print out HIPAA unless you would like to. Also, bring your insurance card, if applicable (only BCBS insurance and Mississippi Physicians care network accepted), and ID. Your therapist will be happy to answer any questions you may have regarding forms.

Adult Intake Form | |
File Size: | 211 kb |
File Type: |

Child/Adolescent Intake Form | |
File Size: | 451 kb |
File Type: |

Informed Consent | |
File Size: | 694 kb |
File Type: |

HIPAA | |
File Size: | 277 kb |
File Type: |

Authorization to Release or Obtain Records | |
File Size: | 198 kb |
File Type: |