Please read ALL the instructions
before completing the required forms. Click on the following
links to go to the form.
***If you
are unable to print and complete the required forms prior to
your appointment, you must
complete them at our office. You will need to arrive 10-15
minutes (per form) early to your scheduled appointment
time, or we will need to reschedule your appointment.
PATIENT
REGISTRATION FORM
You must read the
Treasure Valley Psychological Services HIPAA
document below.
TREASURE VALLEY
PSYCHOLOGICAL SERVICES HIPAA
AUTHORIZATION TO RELEASE
INFORMATION FORM Idaho Statute 16-2428(1)requires
children 14 years and older complete and sign this form for the provider to be authorized to speak with parent(s) or other individuals about patient care.
PARENTAL CONSENT FORM
DR.
M. SNIDER'S INTERVIEW SCREENING FORM
CONNIE KARCHER'S
INTERVIEW SCREENING FORM
DR.
R. ROOT'S INTERVIEW SCREENING FORM
