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    • Home
    • Welcome
    • Services Provided
    • Forms
    • Payment/Insurance Info
    • Contact/Directions
    • FAQ
    • Gallery
  • Home
  • Welcome
  • Services Provided
  • Forms
  • Payment/Insurance Info
  • Contact/Directions
  • FAQ
  • Gallery

Serenity Neuropsychology

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Compassionate Neuropsychological Services

Compassionate Neuropsychological Services Compassionate Neuropsychological Services Compassionate Neuropsychological Services Compassionate Neuropsychological Services

Downloads

Our forms were generated using Adobe Reader in PDF format.


 Please know, if your forms are not completed by the time your appointment is scheduled to begin, we will need to reschedule. Dr. Snider needs approximately 90 minutes to do a thorough intake. Please plan accordingly. For the Patient-Psychologist Agreement and the HIPAA forms, if you prefer, you may print the signature page only. The other forms will need to be printed and completed in their entirety. Please bring all forms to your first appointment along with your I.D., insurance card(s), and medication list.

Authorization for Release of Information (pdf)Download
SAMPLE Authorization for Release of Information (pdf)Download
Registration Form (pdf)Download
Health History Form (pdf)Download
Family/Friends Service Agreement (pdf)Download
Patient-Psychologist Agreement Form (pdf)Download
HIPAA/Notice of Privacy Practices (pdf)Download

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