Hollywood Psychology Center
Acknowledgment of Receipt of
Notice of Policies and Privacy Practices
Authorization of Release of Protected Health Information
Child/Adolescent History Form – Testing
Confidential Youth Intake Information Questionnaire
Consent to Evaluation and Treatment
Coordination of Care between Health Care Providers and Release of Information
Financial and Insurance Information
Forensic Psychologist Form
Forms (testing)
Intake Form
Sample Page
Youth Intake Questionnaire for Parents/Guardians
Forms (testing)
Intake Forms (PDFs)
Intake
Consent for Treatment
Financial
HIPAA Form
Dr. Gast is not Forensic Psychologist