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Intake Forms
In order to optimize our time together during your first session, fill out the intake form, and one of our providers will be in contact to follow up. Also, please complete these forms below and bring them with you to your visit.
Authorization
Intake
HIPAA
Agreement
First Name
*
Last Name
*
Email
*
Phone
Birthday
Month
Preferred Method of Contact
*
Choose one
What Are You Hoping to Work on Together?
*
Appointment Availability Dates/Times
*
Submit
Home
About
About Us
Therapists
Intake
FAQ
Blog
Anxiety/Depression
Trauma/PTSD
ADHD
Addiction
Other Disorders
Contact
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