First Appointment Forms

Please complete the following forms for a first appointment:

English:

• Registration Form
• Email Authorization Form
• Consent for Treatment Form
• HIPAA Privacy Notice
• Authorization to Exchange Confidential Information

Spanish:

• Registration Form (Spanish)
• Email Authorization Form (Spanish)
• Consent for Treatment Form (Spanish)
• HIPAA Privacy Notice (Spanish)
• Authorization to Exchange Confidential Information (Spanish)

Financial Assistance Forms

To apply for financial aid, please complete this form:

• Financial Assistance Application