Forms

Please complete the appropriate forms before your first appointment.

To help us make the most of your first session, please download, complete, and bring the following forms to your appointment. If you have any questions about which forms apply to your situation, don't hesitate to contact us.

New Client Intake Form

General information about the child and family, reason for referral, and developmental history.

Click to Access New Client Intake Form

Consent for Treatment

Authorization for therapy services and acknowledgment of office policies.

Click to Access Consent for Treatment Form

HIPAA Privacy Notice & Acknowledgment

Your rights regarding the privacy of your health information.

Click to Access HIPAA Privacy Notice & Acknowledgement Form

Need Help?

If you are unable to download or print the forms, please arrive 15 minutes early to your first appointment and we will provide paper copies. You may also contact us at (803) 487-1119 or Johannah@carolinatotalchild.com.