Patient Forms and Policies

Patient Policies

HIPAA Notice of Policies & Practices
Credit Card on File Policy
Financial Procedures & Payment Policy
Appointment Cancellation Policy

Patient Forms

Treatment Confidentiality & Custody Determination
Court Counseling Agreement
Patient Agreement & Consent
Unable to Contact Parent or Guardian
Parental Consent
Authorization for Release of Information

For more information call 610.544.2110 or email us at