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If you're a new client, please review the HIPAA information contained in the forms below and then fill out the Wellness Intake Form and Health Questionnaire and bring them with you to your first appointment. Also, please note that we ask that clients not wear perfumes or scented lotions to the office due to sensitivities to scents (sometimes migraines are triggered by scents).
HIPAA Forms to read (need NOT print)
Wellness Intake 2011 Form (print and fill out)
2011 Health Questionnaire (print and fill out)
Additional Intake Information for Dr. Steele (print and fill out)
Crystal Whitlow, Jenifer Hill, Cyndi McCay, Susan St. Ville, Heidi Wringer and Kate Barron are licensed Master's level therapists and have a different schedule of information which you can access below:
Additional Intake Information for Master's Therapists
If you would like your therapist to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete the form below to authorize release of psychotherapy information:
Release of Information Form |
