Patient Forms:

Appointment Request Form

Payment Agreement Form

Consent to Treat Form

Information Privacy Rights Form

Intake Form

this is a form you can fill out on your computer.

Make sure you “Save” after filling out your information. Then you can either print out the form or email it to the doctor prior to your first visit.

Hypnotherapy Intake Form

You will need Adobe Acrobat Reader to open these files.

Click one of these links to download the program.

Acrobat Reader for Windows Acrobat Reader for Mac