Helpful Forms

Registration Form

If you are a new client, please complete this form and bring it with you to your first appointment. If you forget, no worries — we have copies at the office. This just saves a little time.

Registration Form

 

Authorization for Release of Information

If you would like to authorize us to coordinate care with another provider (such as a primary care doctor, or a psychiatrist), please complete this form and bring it with you:

Authorization For Release Of Information

 

Have questions, comments, or want to schedule an appointment?

Information submitted via this form is encrypted for privacy. If after clicking “Send” you are not taken to a “Thank you” page, your email did not go through. Please call us directly at (414) 377-0504.

Please do not use this form for emergencies or crisis situations. If you are having an emergency, please dial 911 or go to your nearest emergency room.

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