Patient Forms
New-patient forms & intake
Completing your paperwork before your first visit saves time and gets you into treatment faster. Download the forms below to print and fill out, or use our secure electronic forms.
Fastest option
Complete your forms online
Fill out and submit your intake securely from any device — no printing needed.
Online intake is coming soon
Until then, call or text your clinic and we will get your paperwork to you or complete it at your first visit.
Call Gulfport (228) 832-8327Diamondhead patients can call or text (228) 255-3533.
Print & bring
Downloadable forms (PDF)
Print, complete, and bring these to your first appointment.
New-patient intake packet
Personal, insurance, and medical-history forms for your first visit.
Download PDFMedical history questionnaire
Your health background so your therapist can plan the right care.
Download PDFNotice of privacy practices
How we protect and use your health information (HIPAA).
Download PDFConsent to treat & financial policy
Authorization for care and an overview of billing and payment.
Download PDFNeed help with any form, or want us to email a secure link? Call or text your clinic — Gulfport (228) 832-8327 or Diamondhead (228) 255-3533.
Ready to get started?
Bring your completed forms to your first visit — or book now and we'll help with the rest.