Referral FORMS for New clients

To start therapy for your child please download the  REFERRAL FORM and CONSENT AND FINANCIAL FORM. 


These can be emailed back to Office@TherapyTalk.org or faxed to 844-708-0619.


REFERRAL FORM (pdf)
Download
Consent and Financial Form (pdf)
Download
Notice of Privacy Practices Policy (pdf)
Download
Cancellation Policy (pdf)
Download
Telehealth Consent (pdf)
Download
COVID-19 GUIDELINES - (pdf)
Download
Authorization for Release of Records (pdf)
Download