Intake forms & documents
The following forms should be completed and presented to your therapist at your initial appointment. If you are unable to print these documents, please notify your provider so that the documents can be made available to you to complete at your initial session- please arrive 30 minutes prior to your scheduled appointment if you need to complete paperwork.
Insurance coverage information should be obtained by contacting your carrier prior to your initial session. You should inquire regarding: your plan's participation with your provider, your copay, if you have a deductible, if you need prior authorization for treatment and if you need a referral.
Insurance coverage information should be obtained by contacting your carrier prior to your initial session. You should inquire regarding: your plan's participation with your provider, your copay, if you have a deductible, if you need prior authorization for treatment and if you need a referral.
| Professional Services Agreement |
| Signature Packet/Consents |
| HIPAA Notice |
| HIPAA Privacy Summary |
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Our location
21 Princeton Place, Suite 100
Orchard Park, NY 14127
phone: 716.539.9232
fax: 716.539.9230
Orchard Park, NY 14127
phone: 716.539.9232
fax: 716.539.9230
