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

 

Forms

Privacy Notice

Click here to for a copy of our HIPAA Privacy Notice

Online Electronic Forms

Paper Forms

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.

 

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 $40 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.

 

Forms 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.