Patient Intake Forms
Please review and complete the informed consent, privacy policy, and payment agreement forms at your convenience before your appointment. Please also upload any relevant medical records below, including prior neurological or neuropsychological evaluations and brain imaging.
Informed Consent
Please review and sign this informed consent agreement prior to your assessment.
Privacy Policy / HIPAA
Please review and acknowledge our privacy policy as part of your intake process.
Release Authorization
Use this form to authorize the release of information to and from our office when you need to share records with other providers or family members.
Payment Agreement
This form contains information about cost and payment. Please provide your insurance information if applicable and acknowledge your financial responsibility.
Secure Records Upload
Use this link to securely upload your medical records and documents to our office.