Wait List Form

To fill out the Wait List Form, click on the link and a form will open.  Fill it out and click submit

Patient Policies

New Patient Packet

To access the New Patient Packet, click on the link below. The packet will open. Please fill out and hit submit


Child Registration Packet

To access the Child Registration Packet, click on the link below. The packet will open. Please fill out and hit submit.


Medical Release Form

To access the Medical Release Form, click on the link below. Please fill out  the  form and hit submit.

Health Care Proxy Form

To fill out the Health Care Proxy Form, click on the link and a form will open. Please fill out the form online and hit submit.

Financial Responsibility Form

To fill out the Financial Responsbility Form, click on the link and a form will open. Please fill out the form online and hit submit.

HIPAA (Fill Out Yearly)

To fill out the HIPAA Form, click on the link and a form will open. Please fill out the form and hit submit.

Child's ADHD Follow Up Form

To fill out the Child's ADHD Follow Up Form, click on the link and a form will open. Please fill out the form and hit submit.

Adult ADHD Form

To fill out the Adult ADHD Form, click on the link and a form will open. Please fill out the form and hit submit.

IIEF 5

To fill out the IIEF5, click on the link and a form will open. Please fill out the form and hit submit.

IIEF15

To fill out the IIEF15 click on the link and a form will open. Please fill out the form and hit submit.

Adult Sleep Questionnaire

To fill out the Sleep Consult packet, click on the link and a form will open that you can fill out online and submit.

Child Sleep Questionnaire

To fill out the Child Sleep Questionnaire, click on the link and a form will open. Please fill out the form and hit submit.

TMS Forms

 Please email here if you have any questions about the forms below.



Please fill out either of the forms below to see if you are qualified for treatment