Client Intake Forms
Here you’ll find links to our new client intake forms which can be filled out online before your first appointment.
Please email us if you need assistance or to submit any completed forms at carolyn@carolyncolepsych.com.
New Patient Forms
HIPAA Notice of Privacy Practices Acknowledgement (pdf)
Informed Consent for Participation in Treatment (pdf)
Patient Information Intake (pdf)
Additional Documentation & Forms*
Authorization to Release Information (pdf)
Coordination of Care with Other Medical Providers (pdf)
Informed Outpatient Information (pdf)
Notice of Privacy Practices (pdf)
Outpatient Services Agreement for Collaterals (pdf)
*Dr. Cole may request additional forms be filled out in order to coordinate care with other providers and/or collaterals.
