Pam Bass Forms

The following links will open a few pdf files. Please print out and fill out all forms.  Signatures are required in several places. Please read carefully.

**  Intake1

**  ConsentConfdtlyOfcPol

**  SYMPTOMCHKLST

 

 

*Financial Policy & Billing Agreement[1]

This one is an Office & Financial Policy.  All new clients please print this off prior to your first appointment and bring them with you to the first session.

 

 

*treatmentagreement4minor [ONLY if I am seeing a minor-under age 19 years];

 

If you are coming in for marital or relationship issues, please also fill out (one for husband/wife)  the following form:

MARITAL INFORMATION SHEET2

Need To Make A Payment?

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