Forms

Please click on each link below that is pertinent to your upcoming visit. You can fill out the documentation directly online. If you have any questions, please call us at 859.554.0740.

For adult clients, please fill out ALL of the following:

Adult Intake, Business Policies, Telehealth Disclosure, Credit Card Consent, Insurance Form, Cancellation Policy

For child clients, please fill out ALL of the following:

Child Intake, Business Policies, Telehealth Disclosure, Credit Card Consent, Insurance Form, Cancellation Policy and PHI Release Form.

Adult Intake Form

Child Intake Form

Foster Care Intake Form

Insurance Form

Telehealth Disclosure

Credit Card Consent

Business Policies

Cancellation Policy

PHI Release Form

Printable Forms

If you prefer to print documents instead, please use the buttons below. Simply download and print the corresponding forms pertinent to your visit with us. Please fill them out prior to your first visit. If you have any questions, please call us at 859.554.0740.