NEW CLIENT INTAKE
Secure & Confidential

This form uses 256-bit SSL encryption to protect your personal health information in compliance with HIPAA regulations.

New Client Intake Form

Please complete this form before your first appointment. All information is confidential and secure.

Secure Intake Form

This area would contain a HIPAA-compliant form integration such as:

  • • Monday.com WorkForms
  • • SimplePractice Client Portal
  • • TherapyNotes Intake Forms
  • • Custom encrypted form solution
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