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Forms and Client Information

Forms and Information for Clients

The following page contains links to information and forms required for new clients. 

 

  • Client Information & Consent To Treatment (Click To Open)

 

  • Client Application (Click To Open)

 

  • Joint Notice Of Privacy Practices (Click To Open)


  • Telehealth Consent Form (Click To Open)


  • Grievance Procedure (Click To Open)

 

Office Hours

  • Monday: Closed
  • Tuesday: 9-8 pm.
  • Wednesday: 2:00 p.m. - 8:00 p.m.
  • Thursday: 9 - 7 p.m.
  • Friday: Closed

Office Address

10218 N. Port Washington Rd.
Suite 1-H
Mequon, WI 53092

Office Phone

414-375-9273

  • Home
  • About Me
    • Policies
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  • FAQ's
  • Forms
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