If you’re a new client, please complete the following forms and bring them to your first therapy session.
Six required forms:
1. Consent for Services
2. Client Information
3. 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.
4. Receipt of Notice
5. Credit Card Payment Authorization
6. Electronic Communication Consent
Optional form: If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of Protected Health Information (“PHI”)
Authorization for Release of Information
For other providers making referrals to Aspire: