Intake Forms

Neurofeedback Forms

Please locate the appropriate forms, fill them out and bring them to your first appointment.

Neurofeedback Informed Consent Disclosure (neurofeedback)

Neurofeedback Symptom Checklist (neurofeedback)

Patient Physical Assessment Form (neurofeedback)

HIPAA Notice (neurofeedback)

Counseling Forms

Please locate the appropriate forms, fill them out and bring them to your first appointment.

Adult Intake Form (counseling)

Disclosure and Informed Consent Form (counseling)

Adolescent Intake Form (counseling)

Minor Intake Form (counseling)

Disclaimers (counseling)

Unsecure Transmission Guidelines (counseling)

HIPAA Notice (counseling)

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