Please complete the following and bring with you to your first appointment:

 

For new patients, 18+:

 

For new patients, 12-18 years old, or for those still in high school:

 

For new patients, 5-11 years old:

 

For your records:

SMHC Financial Policy – client copy

SMHC HIPAA Compliance – client copy

 

Miscellaneous:

SMHC Release of Information