On-line Forms

Forms for Download

PDF Format      HIPPA Form – Notice of Privacy Practices for Protected Health Information

PDF Format      Client Consent Form

PDF Format      Medical Information Release Authorization Form

We have included our required standard forms here in both MS Word and PDF formats for immediate download. Forms may be faxed to us to open a patient’s case file prior to an appointment.

Here is the normal patient’s case process:
(1) Obtain a doctors order for a psychological or neuropsychological evaluation
(2) Download the HIPPA and Consent forms.
(3) Client or Legal Guardian signs the HIPPA and Consent forms
(4) FAX a copy of the doctor’s order, signed HIPPA form, signed Consent form, and all client insurance information to 817-750-1237.

Please make sure you include a name and number of a contact person with the information being faxed to the office.