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Providing mental health services in the Chattanooga area since 1999

Client Registration and Information

STANDARD NOTICE: Right to Receive a Good Faith Estimate of Expected Charges Under the No Surprises Act

To expedite the check-in process at your first appointment, please print and complete the appropriate forms to bring with you.

Adult Intake Forms

Child and Adolescent Intake Forms

Consent to Receive Services

Please print and complete the following form if you would like to coordinate care with another provider (primary care physician, psychiatrist, etc.). If you would like psychological assessment/evaluation information sent to your doctor, you must complete and submit this form.

Authorization to Release Protected Health Information

Telehealth Forms

These forms are required for all clients utilizing telehealth services.

Telehealth Informed Consent

Telehealth Credit Card Authorization