Augusta:

3633 Wheeler Road, Suite 365 | Augusta, GA 30909

Mon-Fri: 9:00am-5:00pm | Evening Appointments Available

Thomson:

2508 University Drive | Thomson, GA 30824 with Family Care Group

Mon-Fri: 9:00am-5:00pm | Evening Appointments Available

Contact Us - 706-432-6866

Forms

Unfortunately, HIPPA requires a lot of information to be completed. As a result, we have paperwork that is necessary to establish you as a patient in our office.

Your Patient Information Form includes the following:

  • Your demographic information
  • Your insurance information and your permission to file your insurance
  • Our office policies that affect your schedule of sessions
  • How to reach us in emergency situations
  • Confidentiality policies
  • Your rights as a patient in our office
  • Our responsibilities as therapists
  • Our social media policy
  • Our cancellation policy

Patient Information Form Patient Information Form

Other Forms

You will also see our Release of Information, Consent for Treatment of a Child, Child & Adolescents Interview, Informed Consent for Fight Club, Teen & intake and Measures your Therapist may send you.

Release of Information Release of Information

Consent for Treatment of a Child Consent for Treatment of a Child

Child & Adolescents Interview Child & Adolescents Interview

Informed Consent for Fight Club Informed Consent for Fight Club

Teen & Intake Teen & Intake

Measures Measures

It's a lot to absorb and we realize that it's difficult to take it all in. If you have any questions about the paperwork, please don't hesitate to ask us. We are happy to help.