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 Aid Forms

To apply for financial aid, please complete this form:

• Financial Aid Application (English)

Para solicitar ayuda financiera, por favor complete este formulario:

• Financial Aid Application (Spanish)