Adult seeking treatment for yourself

Adult Intake Form
Download
Adult Medical History Form
Download
Adult Treatment Goals Form
Download
Health Insurance Portability and Accountability Act (HIPAA) Acknowledgment Form
Download
WA Notice Form
Download

Minor or an adult seeking treatment for your minor child

Child intake form
Download
Child Family History Form
Download
Health Insurance Portability and Accountability Act (HIPAA) Acknowledgement Form
Download
WA Notice Form
Download
The forms above can be electronically filled using Acrobat Reader and then print, or you can print, and hand fill them. Please do not email forms to your provider unless they have informed you it is o.k. If you choose to email these forms to your provider, please be aware that they will NOT be HIPPA protected for privacy.