~ ONLINE PATIENT PRE-REGISTRATION ~


  (Do NOT fill out a Pre-registration Form if you have already scheduled an appointment with us.)

 

 Adult Pre-registration Form

Child/Adolescent Pre-registration Form

 

Please fill out the appropriate Pre-registration Form and an intake worker will call you within 2 buisness days to offer you an appointment time. You may also call our office directly between 9am-5pm, Monday through Friday at 610-892-3800.

                         ** If this is an emergency go to your nearest crisis center                                    or hospital emergency department. **

 

 

 

 

~ PRINTABLE FORMS ~


Once you have scheduled an initial appointment with us you have the option of printing and filling out the appropriate forms below and bring them with you to your initial appointment. Or you may fill them out at the office when you come for your first visit.

 

Adult Forms: (If you are coming for marital or couples counseling have both parties fill out all four forms.) 

      1. Adult History Questionnaire

      2. Adult PHQ-9 

      3. Adult GAD-7

      4. Couples Questionnaire

 

Adolescent Forms: 12-18 years old

      1. Adolescent Questionnaire

      2. Adolescent PHQ-9

      3. Parent Questionaire for Adolescent

 

Child Forms: under 12 years old

      1. Development History of Child 

 

 


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