Please make sure to review and sign these forms at least 24 hours prior to your first appointment. Para formularios y documentos de admisión en español, haga clic aquí.
Consent For Treatment Via Telehealth
Informed Consent: Lauren Reminger
Informed Consent: Alba Hernandez
It is our policy to have a credit card on file. Your card will automatically be charged at the time of service.
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
Good Faith Estimate For Health Care Items & Services: Alba Hernandez
Please complete, sign and return this form if you would like to authorize the release of Personal Health Information.
DISCLAIMER: IF YOU ARE EXPERIENCING A MENTAL HEALTH EMERGENCY, CALL 911 OR VISIT YOUR LOCAL EMERGENCY ROOM.
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.