Forms

Forms

Testing Forms

FORMS

Other Forms and Policies

Authorization to Release Information: Authorization to Release Information

​Abridging a Report: Abridging a Report

​Request for Records of Services Provided: Request for Medical Records

Credit Card Authorization: Credit Card Authorization

Request for Additional Services: Request for Additional Services

Waiver of Feedback Session: Waiver of Feedback Session

Services Included in Fee: Chidekel IEE Fee Schedule 1-19.pdf

Consent for Consultation-Psychotherapy: Consent for consultation-psychotherapy

Consent to Treat a Dependent Adult: Consent to treat a dependent adult 9-17