Intake Forms

You will be required to create a client portal account to sign the necessary agreements and provide some background information prior to your first appointment. All required paperwork will be sent to your client portal account to be reviewed/completed online.

For your reference, below are PDF copies of the required paperwork and our policies regarding consent, privacy, scheduling, & cancellations.

For more information on setting up & accessing your client portal account, click here.

For any questions related to your portal account, paperwork, or appointment scheduling/rescheduling, please contact our Intake Department at 630-571-5750 x. 224.

Consent for Services

Notice of Privacy Practices

Client Information Form

Client Contacts Form

Client History Form

Client Insurance Form

Payment Authorization Form

Couples Relationship Inventory

Pediatric Neuropsych Testing Packet

Adult Neuropsych Testing Packet

IMPORTANT REMINDER: If you cancel your intake appointment less than 48 hours prior OR if you fail to show at your intake appointment, you will be charged a $120.00 fee.