FORMS TO DOWNLOAD

Required for new patients:

Please print, fill out, and bring these forms to your first session.

  • New Patient Intake Form

    • This form will allow you to provide important information to Lauren Tabone, MSN, NPP prior to the first session. If you did not print and fill out at home. Please arrive to appointment 10 minutes before start time to fill this out in the office prior to the session.

  • HIPPA Privacy and Consent Form

    • This serves as your notification of your rights to privacy, under the Health Care Information Portability and Accountability Act. Please print out this notification and keep it for your own records. Please bring your consent form to first session.

  • Practice Policies and Consent Form

    • This form will provide you with information about office policies. Please read the information carefully, and sign the authorization prior to your first visit with Lauren Tabone, MSN, NPP.

  • Credit Card Authorization Form

    • Lauren Tabone, MSN, NPP will hold your appointment for you in her schedule, and in return requests that you fill out a credit card authorization form. Your card will only be charged in the event of a cancellation less than 24 business hours in advance of your appointment, or for any services rendered (telephone session, report writing, etc.) without payment provided at the time of service. Please read carefully and sign the authorization prior to the first visit.

  • Tele-therapy Consent form

    • This form provides information about tele-therapy (video sessions). Please read carefully and sign the authorization prior to the first visit.

Optional forms: