CLIENT FORMS

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Required Intake Documents

Please make sure to review and sign these forms at least 24 hours prior to your first appointment.

Privacy Practices

In Case Of Emergency

Informed Consent, Practice Policies, Consent for Telehealth: Lauren Reminger

Billing Forms

It is our policy to have a credit card on file. Your card will automatically be charged at the time of service.

Payment Information & Authorization

Good Faith Estimate For Health Care Items & Services

To increase transparency in healthcare billing as required by the “No Surprises Act”, effective January 1, 2022.

Good Faith Estimate For Health Care Items & Services: Lauren Reminger

Release of Information

Please complete, sign and return this form if you would like to authorize the release of Personal Health Information.

Authorization For Disclosure of Health Information

ALL INFORMATION, RESOURCES, WRITINGS, BLOG POSTS AND MATERIAL OFFERED/PROVIDED ON THIS SITE AND ASSOCIATED SOCIAL MEDIA PAGES ARE NOT INTENDED TO BE, ACT AS A REPLACEMENT FOR THERAPY, MENTAL HEALTH SERVICES OR ADVICE PSYCHOLOGICAL/MEDICAL. IT DOES NOT CONSTITUTE A PROVIDER/PATIENT RELATIONSHIP. FOR QUESTIONS, SUPPORT AND/OR HELP REGARDING MENTAL HEALTH AND MEDICAL NEEDS, PLEASE CONSULT DIRECTLY WITH A MENTAL HEALTH PROVIDER. THE AHM WEBSITE PROVIDES GENERAL INFORMATION WHICH IS CLAIMED, BUT NOT WARRANTED, TO BE CORRECT AND UP-TO-DATE. AHM ASSUMES NO RESPONSIBILITY FOR ACTIONS OR NON-ACTIONS TAKEN BY PERSONS WHO HAVE VISITED THIS SITE, AND NO ONE SHALL BE ENTITLED TO A CLAIM FOR INJURIOUS RELIANCE ON ANY INFORMATION PROVIDED OR EXPRESSED.

CLIENT FORMS

Required Intake Documents

Billing Forms

Good Faith Estimate For Health Care Items & Services

Release of Information

Other Consent Forms

Reduced Fee Documents

Helpful Information

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