New Clients, please complete the forms below and bring them along with your insurance information, if available, to your first therapy session.
- Client Psychotherapy Intake Form
- Treament Consent Form
- Insurance Form
- Credit Card Agreement Form
- Financial Hardship Form
- Price List
Synergy has it's own cancellation policy which you will receive in your welcome packet. It affords you the opportunity to make-up your session, void of losing any money or time.
If you would like Gina to coordinate care with another provider (psychiatrist, primary care physician, etc.), complete the form below, allowing authorization to release psychotherapy information.
- Authorization to Disclose Information Form
- Synergy's disclosure form is reviewed at intake.
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