The following forms are required for new pediatric patients.
Please print and complete prior to your appointment.
If your child will be seen for an ADD/ADHD evaluation the following additional forms are required.
Please print and complete prior to your appointment.
The following forms are required for all new adult patients.
Please print and complete prior to your appointment.
If you are an adult patient that will be seen for depression, anxiety or bi-polar disorder the following forms are required.
Please print and complete prior to your appointment.
All private pay patients (new or existing) who are applying for the GTHC sliding fee scale program must complete and return the form below.
If you are a new patient, you will need to submit the New Patient Packet (above) along with this form.