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New Patient Application & Forms

Forms 

  • Practice Information

    • Payment Policy 

    • Cancellation Policy 

    • Insurance Policy 

  • Notice of Privacy Practices (HIPAA Consent Form) ​

  • Authorization for Release of Medical Records

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Adverse Childhood Experiences Questionnaire 

Mental Health

Screening Form

Substance Use

History

Amino Acid Imbalance Questionnaire

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