Daring Minds Therapy
Daring Minds Therapy
  • Home
  • Meet Our Therapists
    • Erica R. Schroeder, LIMHP
    • Maureen A. DeRyke, PMSW
    • Stephen Capecci, LIMHP
  • Client Forms
  • Gallery
  • Getting Started
  • Insurance & Billing
  • Our Services
  • OUR PRIVACY POLICY
  • No Surprises Act
  • More
    • Home
    • Meet Our Therapists
      • Erica R. Schroeder, LIMHP
      • Maureen A. DeRyke, PMSW
      • Stephen Capecci, LIMHP
    • Client Forms
    • Gallery
    • Getting Started
    • Insurance & Billing
    • Our Services
    • OUR PRIVACY POLICY
    • No Surprises Act
  • Home
  • Meet Our Therapists
    • Erica R. Schroeder, LIMHP
    • Maureen A. DeRyke, PMSW
    • Stephen Capecci, LIMHP
  • Client Forms
  • Gallery
  • Getting Started
  • Insurance & Billing
  • Our Services
  • OUR PRIVACY POLICY
  • No Surprises Act

Intake paperwork

CLIENT INTAKE & INSURANCE INFORMATION (pdf)Download
Client Agreement-Consent-HIPAA (pdf)Download
Child.Adolescent PTQ 2 (pdf)Download
Adult PTQ (pdf)Download
PHQ-9 and GAD-7 Form_a (pdf)Download
Release of Information (pdf)Download
Medication Provider- Coordination of Care (pdf)Download
Primary Care Provider- Coordination ofCare (pdf)Download

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