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New Patients

Please print out and complete the New Patient Psychotherapy Agreement and either the Adult Intake Form or the Child Youth Intake Form and bring them to your first appointment. Also, please print out and sign Release of Information Form so that we can communicate with the referral source and other important people in your life. These are .pdf files requiring Adobe Acrobat Reader.
 

Other Optional Forms

There are a number of other forms that the Center for Integrative Psychology uses when they are indicated. When we meet we will instruct you about which form to complete, and how we would like you to do it. We list these forms on our website so they are conveniently available.
 
123_Magic.pdf
Opens with: Adobe Acrobat
Alzheimers_Disease_Risk_Assessment_Questionnaire_for_Website.pdf
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Amen_Clinic_ADD_Brain_Type_Questionare_for_Website.pdf
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Amen_Clinic_Anxiety_Depression_Questionnaire.pdf
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CIP_Authorization_to_Release_Information_Form_for_Website.pdf
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CIP_Child_Teen_Intake.pdf
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CIP_adult_intake_form.pdf
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CNS_Questionnaire.pdf
Opens with: Adobe Acrobat
Change_Your_Brain_Body_Questionnaire_for_Website.pdf
Opens with: Adobe Acrobat
Hormone_Health_Checklist_for_MEN_for_Website.pdf
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Hormone_Health_Checklist_for_WOMEN_for_Website.pdf
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Hows_Your_Memory_Screening_Questionnare_for_Website.pdf
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New_Patient_Agreement_2016.pdf
Opens with: Adobe Acrobat