If you are a new client, Please Read & Complete the following forms to the best of your abilitiy.
Bring the completed forms to your first therapy appointment, along with your Photo ID and Insurance Card. If you have any questions related to the paperwork, they will be addressed during your first appointment.
If you do not have access to a printer, you may fill out the forms on any computer and e-mail them to our office. Please call us and inform us if you do decide to e-mail your forms, so that we can confirm receipt.
Office Phone Number: (202) 544 - 5440.
Office Email: [email protected].
- Patient Registration Form
- HIPPA Notice Form
- Consent for Treatment Form
- Release of Information to Primary Care Physician *
- Confidential Personal History Form
If you would like to coordinate care with, or release information to a third party (e.g. an attorney, a family member, a doctor other than your primary care physician), complete this form to authorize release of your therapy information:
*Primary Care Physician Release & Generic Release Forms are Optional Forms Only to be Completed upon Need.
Note: To download Adobe Acrobat Reader for free, Click Here.
All Forms as a Single PDF - Print Double-Sided: CCCC New Appointment Forms.
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