Forms & Questionnaires

Please complete only appropriate paperwork for your concern listed below and upload clear pictures of the front and back of your insurance card(s). Click here for more information on insurance and billing.
Once we have received ALL NECESSARY documents, our clinical team will review your paperwork and we will be in touch within 2 weeks to let you know the next steps and timeline. Please note: we do not have the capacity to respond to questions about paperwork status. 

Are you currently enrolled in college courses?

College students can find their necessary paperwork below.

Step One: Upload Insurance Card

Step Two: Complete these THREE documents. These are necessary documents for ALL services. We cannot schedule an appointment without these documents.

Step Three: In addition to the above necessary documents, please complete ONE of from this list below depending on service(s) you are requesting. DO NOT COMPLETE ALL FORMS. ONLY complete the forms specific to your concern.

Vision & Hearing

Prior to the consultation appointment please have the client’s vision and hearing screened by their medical provider.

Neurological Injuries

If either you or your child has had any neurological injuries that have been treated, please have your medical provider clear you for testing, and provide us with any reports summarizing the injury and treatment.
Click or drag files to this area to upload. You can upload up to 15 files.
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