For new clients, please complete the Aspire Intake Forms electronically by clicking the button below: 

Aspire Intake Forms

 

If you would rather bring hard copies to your first therapy session, please click the PDF icons below each form to download:

Required Forms:

1. Consent for Services

2. Telehealth Consent for Services (for telehealth services only)

We now offer telehealth appointments for patients who wish to have their therapy session by phone or device. Please complete the telehealth consent form, in addition to the regular consent, if you plan to use telehealth services.

3. Client Information

4. Notice of Privacy Practices

*Please read this Notice; however, it is not necessary to print unless you would like a copy for your own records.

5. Receipt of Notice

6. Financial Agreement

Optional form—If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form either electronically or by downloading the PDF to authorize release of Protected Health Information (“PHI”):

Authorization for Release of Information

 

Authorization for Release of Information