Please take the time to read and fill out these forms prior to your intake appointment. All information disclosed will be kept confidential. Thank you.

Forms for adult clients

Client History and Information Questionnaire for Adult Clients
Healing Heart’s Office Policies and Professional Disclosure
Notice of Privacy Practices (HIPPA)
Consent to Release Information

Forms for minor clients to be filled out by parent or legal guardian

Client History and Information Questionnaire for Minor Clients
Consent for Treatment of a Minor
Healing Heart’s Office Policies and Professional Disclosure
Notice of Privacy Practices (HIPPA)