Psychology &
Counseling
Associates, P.C.
Forms
Patient Information Questionnaire
Client Information and Consent toTreatment/Evaluation
Authorization Form (PCA)
Financial Policy
Authorization Form (Release to Physician)
Form C - Anxiety Screening (GAD-7)
Form B - Patient Health Questionnaire for Adolescents (PHQ-A)
Form D  - Patient Health Questionnaire (PHQ-9)
Form A - Pediatric Symptom Checklist (PSC-17)
General Forms
Intake Forms
For Children (Ages 12 and Below):
Patient Information Questionnaire
For Adolescents (Ages 13 through 17):
Patient Information Questionnaire
For Adults (Ages 18 and Up):
Patient Information Questionnaire
Form C - Anxiety Screening (GAD-7)