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Forms

Prior to scheduling a visit online, please complete the intake form along with consents and HIPAA forms and submit them in advance of your appointment.
Please print and complete the Consent and HIPPA Forms and return them via email.

Intake Form

  • Date Format: MM slash DD slash YYYY

Additional forms:

You may also complete some forms online that may be relevant to your situation. If you complete any, please bring results to your session.

Adult ADHD Self-Report Scale

A psychological self assessment measuring the symptoms of ADHD in adults.
View on psychology-tools.com

Hamilton Anxiety Rating Scale

A psychological assessment of the severity of symptoms of anxiety.
View on psychology-tools.com

Psymed – OCD TEST

Obsessive-Compulsive Disorder screening test
View on www.psymed.info

Major Depression Inventory

A psychological self-rating scale developed by the World Health Organization designed to measure depression severity.
View on psychology-tools.com

Bipolar Disorder Screening

Instructions: Please answer each question as best you can. Upon completing this form, print your completed form and take it to your health care practitioner.
View on bipolar.stanford.edu

Vanderbilt ADHD Assessment Scale-Parents

Never Occasionally Often Very Often Symptoms 1. Does not pay close attention to details or makes careless mistakes with, for example, homework 0 1 2 3 2.
View on www.myadhd.com

Child Attention Deficit Disorder (ADHD) Screening

This quiz tests whether your child or teen may have attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).
View on psychcentral.com

ADHD Questionnaire for Teenage Girls

View on addvance.com

Panic and Agoraphobia Scale

A psychological self-rating scale that indicates the severity of panic attacks and agoraphobia symptoms.
View on psychology-tools.com

Autism / Asperger’s Quiz

Discover whether you suffer from autism or Asperger’s with this quick screening online test.
View on psychcentral.com

Substance Abuse Screening Checklist

View Here