New patients: Please download the following forms, fill them out, and bring them with you to your first appointment.

For a new child/adolescent, the following forms are needed;

beckett child paperwork.pdf 

release of information.pdf

hipaa form.pdf

hipaa signature form.pdf

outpt services contract.pdf

For a new adult (18 and over), the following forms are needed:

release of information.pdf

hipaa form.pdf

adult initial paperwork.pdf

hipaa signature form.pdf

outpt services contract.pdf

  

© 2008 Dr. Sharon Phillips

 

  

  

 

  

  

Dr. Sharon Phillips and Associates, LLC

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