Forms
Consent for Service (2.5).pdfTo receive service, we ask that the patient (over 12 years of age), and/or their legal custodian (for children under 12 years of age) endorse the following Consent of Service. It will be sent to you to complete online.
To receive service, we ask that the patient (over 12 years of age), and/or their legal custodian (for children under 12 years of age) endorse the following Consent of Service. It will be sent to you to complete online.
Contract for Purchasing Psychological Services (3.6).pdfTo receive service, we ask that the payee of services complete the following Contract. It will be sent to the individual to complete online (or can be printed and sent to us).
To receive service, we ask that the payee of services complete the following Contract. It will be sent to the individual to complete online (or can be printed and sent to us).
Consent to Collect or Share Information (4.4).pdfTo enable collection of information from a 3rd party (or disclosure of information), this form may be sent to the individual to complete.
To enable collection of information from a 3rd party (or disclosure of information), this form may be sent to the individual to complete.