Required – New Client Forms

If you’re a new client, please complete the following forms.

Please call 571-721-1085 or email us at inquiries@psychgroupllc.com to schedule an appointment.

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ADOLESCENT ( Age 17 and younger )

• COMPLETE ONLINE : Adolescent – Intake and Informed Consent Forms

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ADULT FORMS ( Age 18 + )

• COMPLETE ONLINE : Adult – Intake and Informed Consent Forms

Request to Coordinate Care

Click on the link below to request coordination of care with another provider (for example, your psychiatrist, primary care physician, etc.). Complete this form to authorize the release of treatement information:

• DOWNLOAD: Authorization to Disclose Information
• COMPLETE ONLINE : Authorization to Disclose Information

Note: To download Adobe Acrobat Reader for free, click here.