New Patient Forms

Prior to your first session, you will be asked to complete new patient intake forms.  Forms can either be completed in the office, at your first session or via DocuSign.  A DocuSign link will be emailed to you prior to your first scheduled appointment.  

Forms vary by provider at SJPCS.  Below is a general description of the forms. 

The Contact Information Page: This form provides us with your demographic information and informs us as to how you would like to be contacted.

Office Policies/Office Policies Signature Page:  This form includes our Acknowledgment of Informed Consent, Confidentiality Policies, Office Policies and Procedures, Client Rights and Responsibilities, and Financial Agreement.

Notice of Privacy:  This form describes HIPPA compliance policies.

Intake Form: This form will provide your therapist with information regarding the reason you are seeking treatment as well as a psychological brief history.

Release of Information:  This form gives your consent for your therapist to release information to a third party.