Patient Forms


It is helpful if new patients can complete the following forms before their initial visit to Psychology Resources. First, please read the Psychologist-Patient Services Agreement and the Health Insurance Portability and Accountability Act (HIPAA) pages. Then, please print and sign the Consent Form indicating you accept our agreement. Also, please print, complete, and sign the Patient Information form, Financial Policies page, and a Background Information form (complete the Adult form if the patient is an adult, Young Adult form if the patient is a teen, and the Child form is the patient is a child).

If you have any questions or difficulties with these forms, please contact our office.

To give us permission to release your records from Psychology Resources OR to request your records be sent to Psychology Resources from another facility/doctor, please use this form:

 
Under the No Surprises Act, you have the right to receive a “Good Faith Estimate” outlining the expected costs of your medical and psychological care. For more information or to view our standard notice regarding the No Surprises Act, follow the link below: