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Below are the forms that we require at intake (1st appointment). In order to save valuable time, we've added these forms to our web page so that you can fill them out in advance. DR JONES' FORMS: LESA SWANSON'S FORMS: CtDataSheet2.doc (1 page) Outpatient_Services_Contract_-_Swanson.doc (read & sign) Notice_of_Privacy_Policies.doc (read and sign) Personal_History_Questionnaire.doc (generally takes 5-10 minutes) Psychotherapy Assessment Checklist (For adults only - generally takes 30-40 minutes to complete) ** PLEASE NOTE THAT COPAYS ARE DUE AT THE TIME OF SERVICE & THERE IS A $5 CHARGE IF WE HAVE TO BILL FOR COPAYS. |
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