Adult Intake Form
Please fill out this form and bring it to your first appointment. You can also fill out the form electronically and email it directly to your therapist if that’s easier for you.
Adult Intake Form and Privacy Policy
Child Intake Form
A parent or guardian should fill out this form and bring it to the child’s first appointment. You can also fill out the form electronically and email it directly to your therapist if that’s easier for you. If your child is 14 years old or older, they may complete the form themselves.
Child Intake Form and Privacy Policy
Julia Epstein, PMHNP Intake Forms
Informed Consent, Intake Form, and Privacy Policy
Authorization for Release of Records, Informed Consent for Telehealth Visits, and Privacy Policy