office (205) 403-0955
fax (205) 403-0956
2 Riverchase Office Plaza, Suite 115, Hoover, AL 35244-2810

 

COVID-19 Precautions:

Data Breach Notification:

Forms

The Following forms are made available to you to help speed the intake process for new patients.  These forms are in PDF format and may be viewed and printed from Adobe Reader.  If you do not have this viewer it is available from the Adobe website.

Privacy Notice

Click here to for a copy of our HIPPA Privacy Notice

Online Forms

  • Intake form to complete prior to your first appointment.
  • Request forms that need a signature including the Telepsychology Informed Consent and Release of Information.

Paper Forms

These forms may be downloaded, printed, and scanned back to us through the Secure Message and File Transfer Form.

NEW: Telepsychology Informed Consent Form.  Please complete this form if you wish to engage in secure video sessions or phone sessions.

 

If you need information to be released to a third party, the Release of Information Form is available below.

 

We can now receive confidential emails and confidential file transfers.  The secure communication link is available below.

 

Please note our Cancellation Policy

All cancellations must be made 24 hours prior to your scheduled appointment.  Failure to give 24 hour notice or not showing up for your appointment will result in a $70 fee.  If you call and do not reach someone (such as nights and weekends) please leave a voicemail so that we have a record of your call.