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Forms for Downloading 

These forms are available for your convenience.  You will save time if you download, read, and sign these forms prior to your first appointment. 

All forms are in pdf format.  Right click the form and choose "Save as."

FORMS FOR ALL NEW PATIENTS

Consent to Treatment (2 pages)

Notice of privacy practices (2 pages)

ADDITONAL FORMS FOR CHILD & TEENS

Intake form for children and teens (4 pages)

Developmental history (3 pages)

Psychotherapy Services Agreement for children and teens (4 pages)

ADDITIONAL FORMS FOR ADULTS

Intake form (4 pages).

Psychotherapy Services Agreement for adults (4 pages).

OPTIONAL FORMS

Authorization to release information (3 pages).

Insurance Form (1 page)

 

 

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Service areas:

Farmington, Farmington Hills, West Bloomfield, Novi, Royal Oak, Southfield, Walled Lake, Birmingham, Bloomfield, Berkley, Commerce Township, Northville.