Client Forms

  • Sliding Scale Application

    We offer a discounted sliding fee schedule that is based on family size and income. We offer services to all clients regardless of ability to pay. Please complete this application and provide supporting documentation to be reviewed for participation in this program.

  • New Client Forms

    If you are new to working with us, please be sure to fill out each of the following forms, and bring them to your first session.

  • ALERT Wellness Forms

    Medicaid clients, please fill out this form and bring it to your first session.

  • Release of Information

    If you feel that you would like to collaborate your session with another provider, please fill out the following form.