Mountain Lake

New Patients

Forms

We have a number of forms that we ask new patients to sign at their first intake appointment. If you have been scheduled to begin with a clinician, please review these forms in advance of your first appointment. We will ask you to sign them in person when we meet with you. 

AttachmentTypeFile size
ASU Psychology Clinic - Notice of Privacy Practices (updated 2019).docWord (DOC)46 KB
ASU Psychology Clinic - Informed Consent (updated 2019).docWord (DOC)38.5 KB
ASU Psychology Clinic - Clinic Policies Agreement Form (updated 2019).docxWord (DOCX)22.95 KB
ASU Psychology Clinic - Electronic Contact Policy (updated 2018).docxWord (DOCX)22.15 KB
ASU Psychology Clinic - Sliding Scale Application (EW edits 2019).docxWord (DOCX)22.17 KB