if you have any questions regarding the forms, please contact the office manager here officemanager@stridesinpsych.com or here 732-873-5570

Forms For an Adult Client or For a Couple:

• Treatment Consent for Adults
• Intake Form For Adults
• Outpatient Treatment Policies and Contract
• Notice of Psychologist’s Policies and Practices to
  Protect the Privacy of Your Health Insurance Information (HIPAA)
• Permission to Release Information
• Credit Card Authorization Form
• Telehealth Consent
• Health Insurance Claim Form (HICF)

Forms For a Child Client:

• Treatment Consent for Children & Adolescents
• Intake Form for Children & Adolescents
• Notice of Psychologist’s Policies and Practices to
  Protect the Privacy of Your Health Insurance Information (HIPAA)
• Permission to Release Information
• Credit Card Authorization Form
• Telehealth Consent
• Health Insurance Claim Form (HICF)
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