Please click here to be connected to my group practice. This page contains all the forms for my practice.
New Patient Paper Work – Please download, print and complete each form – Please do not date the forms, we will date them on the day of your visit.
Client Information Form Consents and Authorizations Patient Rights/Notice of Privacy Release of Information Form (If you would like PRA to communicate with outside agencies, schools, or PCP – you will need one for each separate contact)
Please note: For clients under 18 years of age, the following forms should be filled out prior to the first session:Parent Questionnaire (For patients 18 & younger) Behavioral Checklist (For patients 18 & younger)
Please do make sure you visit the Forms Page at my group practice, PRA, to be aware of all the group practice policies and procedures, including other helpful forms.
Also, prior to our first appointment, please bring all records from any other medical providers, school testing, IEP plans, 504 Plans, or any other records you think will help me better understand you or your child/adolescent's situation.