Forms

It is truly an honor to know that you have chosen us to help you with your journey for better mental and emotional health!

New Client Information Forms are available on our website, for printing at your convenience!

Most intake information is completed by contacting our office at: 302-376-0621.

In order to make the first visit a little less overwhelming YOU CAN BEGIN FILLING OUT FORMS NOW!

Completing the client information forms in advance is not required. We offer this option so that you may start your process that much sooner!

Since we cannot legally have you submit your information via internet, we ask that you print and complete the forms. You may bring the completed forms in with you at your first visit or you may fax the completed forms to 302-376-6219.

First time clients who wish to request an appointment: Click Here

Clients who have already spoken with a secretary and wish to complete patient information forms: Click Here

Clients with an Employee Assistance Program (EAP), please complete the EAP form:  Click Here

This not only saves time for you and the therapist, it ensures that you are covered for EXACTLY what you are requesting and that you are authorized to see a therapist: Click Here

For all MEDICAID and MEDICARE clients, please fill out this additional packet: Click Here

Insurance