Print out the forms you need at your home or office so you can fill them out and bring them to your appointment.
If you would like, we can make copies for you also. You can fill out the forms here.
Please arrive at least 15-minutes before your appointment.
If you need help in completing your paperwork, please call us prior to your appointment and arrive at least 25-minutes before your scheduled time. (316-295-4800)
Call us before your visit
When you make your initial appointment, please ask which forms and information you need to bring with you. If you like, you can fill out the forms in our office. Let our receptionist know what you prefer.
If you need a PDF reader, you can download Adobe here. (Be sure to uncheck all the addons with this free download.)
If applicable, we will file the appropriate paperwork with your insurance provider or government agency for payment. Be sure to bring the proper information so we can file for you.
Registration Forms Package
RF Patient Registration Package 2024 03 24
- New Patient Registration
- Services Agreement
- Patient’s Rights & Responsibilities
- Privacy Practice Consent
- Fee Schedule
- Sliding Fee Application
- Grievance Policy
Play Therapy Forms
Child Play Therapy Background Forms
- Child Background Information
Mental Health Forms Package
MH Mental Health Forms Package Updated
- MH Acknowledgement
- MH Concerns
- MH History
- MH Treatment Contract
Substance Abuse Forms Package
SA-Substance-Abuse-Package-2024 03 19
- SA Acknowledgement
- SA Concerns List
- SA Personal Substance Use History
- SA Depression Scale
- SA Release of Information
- SA SASSI DSM-5 Screening Inventory
- SA TCU Drug Screen Use
- SA Treatment Contract
Grievance Policy & Form Package
- Grievance Policy
- Grievance Form
Remember to bring your government identification card and current health insurance information.
Call us anytime if you have questions. (316-295-4800)
Our office hours are Monday through Friday from 8am to 9pm. Call anytime to leave a message.
Remember if this is a medical emergency, please dial 9-1-1 to get help.
If you need to talk with someone now, call Sedgwick County’s COMCARE’s Crisis Line at 316-660-7500.