Viewpoint Psychology and Wellness Forms
If you are a new client, the following forms are required to be reviewed and completed prior to your initial visit or consultation. If you are unable to access these forms please contact our administrative staff.
New Patient Intake Forms (both links required unless stated otherwise)
- Profile Sheet
- If you have already completed the Intake Profile previously, or if you have already provided this information previously (including insurance card and license) it is not necessary to resubmit.
- Please include insurance card information. If you do not have a physical card, please provide the number and group ID.
- Intake Package (all documents EXCEPT Profile Sheet)
Individual Forms (Existing Patients)
- Credit Card Payment Authorization (including annual renewal)
- Required to be on file unless alternate arrangements are made
- Patient PCP Coordination of Care
- Authorization to Release and / or Obtain Information
- Treatment Authorization Document Version 10-13-20 - (Complete for Renewal)
Medication Management Forms
Medical Records or General Information Upload
Insurance Card Upload (only for verification or renewal)
Should you have any questions, concerns or trouble completing any of the required documentation please feel free to contact us so we may assist.