If you’re a new client, please print and complete the following forms and bring them to your intake, your first therapy session.
MPP Client Psychotherapy Intake Form
MPP Consent to Treat a Minor Authorization Form
HCFA Insurance Billing Authorization
MPP Clinical History Form
MPP Adult Symptom Screeners
MPP Child/Adolescent Symptom Screeners
Please refer to the following forms for your information. You may print and keep a copy of these policies.
MPP Cancellation Policy
MPP Fee Schedule
MPP Notice of Privacy Practices
If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Authorization to Disclose Information Form
Note: To download Adobe Acrobat Reader for free, Click here.