If you're a new client, please complete the following forms and bring them to your first therapy session.
OPA Telepsych Consent Form - opa-telepsychology-informed-consent-form.pdf
MNM Intake Packet - mnm-intake-packet.pdf
If you are a Neuropsychology client, please complete the following questionnaire in addition to the form and packet above.
Neuropsychology Questionnaire - neuropsychology-questionnaire.pdf
If you would like our Doctors to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information.
Authorization for Release of Protected Health Information - authorization-of-release-form.pdf
If you are a provider looking to refer someone for care, please complete this packet.
MNM Referral Packet - tlc-referral-packet.pdf