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Forms

Park Ridge Psychological Services provides the following forms for your convenience. Please download, print and fill out the appropriate form out prior to your appointment so that pertinent information (such as insurance coverage, personal information, et al) is already taken care of before your first session.

The following forms are available in both Adobe Portable Document Format (PDF) and Microsoft Word document format:

FORMWORDPDF
Initial Information Intake & Informed Consent to Treatment/Evaluation**
22k

45k
Notice of Privacy Practices
27k

81k
Acknowledgement of Receipt of Privacy Notice
21k

60k
History & Questionnaire
33k

24k
Release of Information
27k

44k

**Please complete and submit this information prior to your first visit.

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