TPC Initial Appointment Forms
Please click on the forms below and then after the form appears in a new window, press print.
HOW ARE WE DOING?
TPC Survey
TPC Survey
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For Married Couples
Please print out 1 SET of forms 1 - 5 (2 of No. 4) complete and take with you to your first appointment.
For NON Married Couples
Please print out 2 SETS of forms 1 - 5 complete and take with you to your first appointment.
For Minors
Please print out forms 1 - 7 (skip No.4) complete and take with you to your first appointment.
For Individuals
Please print out forms 1 - 5 complete and take with you to your first appointment.
For Credit/Debit Cards
If you would like to pay with your credit or debit card, you may pay online PRIOR to your appointment
click on here for instructions PAY ONLINE
FORMS
For Married Couples
Please print out 1 SET of forms 1 - 5 (2 of No. 4) complete and take with you to your first appointment.
For NON Married Couples
Please print out 2 SETS of forms 1 - 5 complete and take with you to your first appointment.
For Minors
Please print out forms 1 - 7 (skip No.4) complete and take with you to your first appointment.
For Individuals
Please print out forms 1 - 5 complete and take with you to your first appointment.
For Credit/Debit Cards
If you would like to pay with your credit or debit card, you may pay online PRIOR to your appointment
click on here for instructions PAY ONLINE
FORMS
| 1. Patient Information |
| 2. Therapy Agreement |
| 3. Confidentiality Policy |
| 4. Adult Sympton Inventory |
| 5. Legally Required Notice of Privacy Policy |
| 6. Child Sympton Inventory |
| 7. Consent to Treat Minor |
| 8. Authorization to Release Records |
