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Patient Forms

Listed below are the forms that might be needed for you as the patient. Please fill out the corresponding form(s) that is needed for you, print a copy, and the Counseling Center. If you do not have a printer available, a copy of these forms can be provided for you in person at the clinic.

If you are preparing for your very first visit with TrueTalk Counseling please fill out all forms indicated by the " "

Minor Consent to Treat Form

Form for parents(s)/guardian(s) of a minor and are giving consent to treat.

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Patient Forms

Minor Consent to Treat Form

Form for parents(s)/guardian(s) of a minor and are giving consent to treat.

Cancellation/No-Show Policy Form

Please Fill this out if you are
new to visiting with us.

Electronic Communication Form

Complete this form to agree to communication via electronics

HIPPA Compliance Form

Please Fill this out if you are new to visiting with us.

New Patient Intake Form

Please Fill this out if you are new to visiting with us.

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Patient Forms

Minor Consent to Treat Form Form for parents(s)/guardian(s) of a minor and are giving consent to treat.

Cancellation/No-Show Policy Form Please Fill this out if you are new to visiting with us.

Electronic Communication Form Complete this form to agree to communication via electronics

HIPPA Compliance Form Please Fill this out if you are new to visiting with us.

New Patient Intake Form Please Fill this out if you are new to visiting with us.

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Minor Consent to Treat Form

Form for parents(s)/guardian(s) of a minor and are giving consent to treat.

Cancellation/No-Show Policy Form

Please Fill this out if you are
new to visiting with us.

Electronic Communication Form

Complete this form to agree to communication via electronics

HIPPA Compliance Form

Please Fill this out if you are new to visiting with us.

New Patient Intake Form

Please Fill this out if you are new to visiting with us.