INTAKE FORMS

 

The following intake forms are to be completed by all new clients before their first appointment. 

* Couples need to complete his/her own separate form.

If you are unable to complete your intake forms ahead of time or forget to bring them, please plan to arrive at least 10-15 minutes early. 

Extra forms will be available in the waiting area. The time allotted for the appointment cannot be extended due to incomplete forms. 

 

 

 Please bring the following REQUIRED items to your first appointment:

 

  • Completed and Signed PAI Intake forms

  • Photo ID (of legal guardian, if client is a minor)

  • Insurance card(s) 

  • Payment for copay or other financial responsibility (eg. private pay option)

    • cash - we kindly ask for exact amount.

    • check

    • credit/debit card

PAI QUESTIONAIRE (ADULT)

PAI NEW CLIENT FORM (FAMILY PACKET)

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