New patient documents

Welcome new patients! Save time before your first visit, by filling out paperwork at home. The documents can be filled out using your computer (requires Microsoft Word) or by hand (manual entry). When you have completed them, please print, sign, and bring them to your appointment at HopeCentral.Please call us if you have any questions about these forms. We look forward to serving you!

New Patient Documents for Download

All new patients should complete the two forms below and keep the reference document for your files.

Directions:

  1. Download the selected form to your computer by clicking on the form, and then on the next screen clicking on the download icon (an arrow pointing down).
  2. COMPUTER ENTRY: Open and fill out the form using Microsoft Word.
    MANUAL ENTRY: Print the form and fill it out with a pen.
  3. Bring the completed forms with you to your appointment.

If you have trouble with the forms, you may also arrive at our office 15 minutes prior to your appointment and we can provide copies for you to fill out.

Release of Information Form

Please complete this form if you have medical records from other offices that should be released to HopeCentral. Click here for form

Authorization for Psychological Services

Please complete this form if you will be receiving an Autism Spectrum Diagnostic Evaluation or Executive Function Evaluation. Click here for form