Forms – Vital Life Psychology

Patient Forms

Below are the forms you may be asked to fill out prior to your appointment to help us learn more about you.

ADULT INTAKE
HISTORY QUESTIONNAIRE

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CHILD, ADOLESCENT
YOUNG ADULT INTAKE

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CREDIT CARD
PAYMENT

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EXCUSED
ABSENCE

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FINANCIAL
RESPONSIBILITY

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HIPPA
COMPLIANCE

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PATIENT
REGISTRATION

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RELEASE OF
INFORMATION

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