Patient Forms:
- Authorization to Release Confidential Information
- Consumer Concern Form
- NCS Intake
- PSY Intake
- Request to Correct or Amend Personal Health Information
Referral Forms:
Financial Assistance Forms:
For more information on financial assistance, please go to the Financial Assistance page.
- Fee Reduction Request Form
- Financial Assistance Application and Instructions
- Financial Assistance Plain Language Summary
- Financial Assistance Policy
- Financial Assistance Sliding Fee Scale