For more information:

(603) 247-4191 / drrobin@insightsgroup.net

1245 Washington Road

Rye, New Hampshire 03870

For more information:

(603) 247-4191 / drrobin@insightsgroup.net

1245 Washington Road

Rye, New Hampshire 03870

Forms

INTAKE FORMS

New client information & consent to treatment

     To be completed for all new patients

Privacy notice

     To be completed for all new patients

Adult – clinical summary

     To be completed by patients over the age of 18

Adult – permission to release information

     To be completed by patients over the age of 18

Minor – clinical summary

     To be completed by the parents or guardians of children under age 18

Minor – permission to release information

     To be completed by the parents or guardians of children under age 18
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