Completing these forms will allow us to get to know you, and help us to help you. The Autobiographical Information Form will speed up the interview process in the first session or two. The Professional Services Agreement and the HIPAA forms are legal requirements which we must have before we can begin a professional relationship with you. The Insurance Information Form will help us check on your coverage, which we will do as a courtesy to you.
Please download and print out the forms, fill them out at your convenience, and bring them along to your first appointment with us. If you have any questions, please feel welcome to give us a call at (913) 345-0033.
If you cannot print out the forms at home, we have copies in the office which you can pick up, or we can mail them to you.
We look forward to working with you.
- HIPAA Form – Click Here to Download
- Professional Services Agreement Form – Click Here to Download
- Insurance Information Form – Click Here to Download
- Confidential Adult Autobiographical Form – Click Here to Download
- Confidential Adolescent Autobiographical Form – Click Here to Download
- Confidential Child Autobiographical Form – Click Here to Download