Forms & Consents
Please fill the corresponding form, below before your initial visit.
These forms are on a PDF format so you can type or write on them, once you have filled them you can upload them to the Client Portal or Print it out completely and bring it with you during your Initial Consultation. This will ensure we will use our time together more efficiently.

1--Adult Intake-IEHP | |
File Size: | 5961 kb |
File Type: |

2-Child Intake--IEHP | |
File Size: | 6897 kb |
File Type: |

3-Adult Intake | |
File Size: | 6559 kb |
File Type: |

4-Telehealth Consent | |
File Size: | 75 kb |
File Type: |

5-Child Intake | |
File Size: | 7597 kb |
File Type: |

6- Adulto Intake-IEHP en Español | |
File Size: | 6486 kb |
File Type: |

7-Telemedicine Español | |
File Size: | 79 kb |
File Type: |

8-Intake Adulto/Español | |
File Size: | 6898 kb |
File Type: |

Notice Of Privacy Practices | |
File Size: | 43 kb |
File Type: |

Notice of Privacy Practices en Español | |
File Size: | 28 kb |
File Type: |
Click below "Client Portal"to upload documents to your TherapyPortal into "Blank(put documents here)"
Haga click aqui abajo donde dice "Client Portal" para mandarnos documentos desde su TherapyPortal en el archivo"Blank(put documents her)"
👇🏼
Haga click aqui abajo donde dice "Client Portal" para mandarnos documentos desde su TherapyPortal en el archivo"Blank(put documents her)"
👇🏼
📞
We accept these Insurances
TRICARE, CHAMPVA, IEHP, MHN
TRICARE, CHAMPVA, IEHP, MHN