Dr. Sharon Phillips, LLC
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Patient Forms
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 need to be printed:
Insurance benefits worksheet
Child/adolescent demographic form
Child/adolescent assessment form
Outpatient services contract
HIPAA signature form
Consent to treat a minor
PCP form
For a new
adult
(18 and over), the following forms need to be printed:
Insurance benefits worksheet
Adult demographic form
Adult assessment form
Outpatient services contract
HIPAA signature form
PCP form
The following form is for your review, but does
not
need to be printed out:
Two-way authorization to release information
For a new COLLABORATIVE LAW client, the following forms are for your review:
Collaborative Law Agreement
Collaborative Law Release of Information
Collaborative Law Client Information Form
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