HEAD & HEART THERAPY

Forms
Forms can be filled out electronically through our patient portal. You may also fax completed forms to (844) 479-2683. For individuals who are not a current client of Head and Heart Therapy, it's important to set up a free consultation in order to become a client.
Informed Consent for Telehealth Services
Personal Disclosure Statement
Release of Information
Maggie Nidick, Student Therapist
Other Forms