New Client Paperwork

The following intake forms are to be filled out by all new clients before the intake appointment. If coming in as a couple, each partner fills out his/her own forms.

If you are unable to complete your intake forms ahead of time or forget to bring them, you will need to arrive at least 30 minutes early. The time allotted for the appointment cannot be extended due to incomplete forms.

Treatment Agreement & HIPAA

19 years and older

18 years and younger

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Get in Touch

Jacksonville
1215 Jackson's Way, SW
Jacksonville, AL 36265
(Across from Jacksonville High School)
(256) 239-5662
 | Phone
(256) 217-4162 | Fax
» Get Directions


Boaz
605 A Medical Center Pkwy
Boaz, Al 35957
(256) 239-5662 | Phone
(256) 217-4162 | Fax
» Get Directions