Forms

Electronic Forms

While we focus on social distancing in order to slow the spread of COVID-19, we will be offering HIPAA-compliant online individual and couple’s therapy. The following electronic forms should be completed and submitted by new clients:

Printable Forms

For in-person appointments, new clients should complete the following forms and bring them to your first therapy session:

New Client Information Form
Consent to Treatment and Confidentiality Form
Notice of The Brandywine Center Privacy Policy
Cancellation Policy Form

If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.) complete this form to authorize release of psychotherapy information.
Authorization to Disclose Information Form

More Questions?

Contact The Brandywine Center today for further information