Serenity Neuropsychology PLLC

M Snider PhD

If you are unable to print and complete the forms prior to your appointment, we will need you to complete them at our office. Please leave a message indicating this need and arrive a minimum of 75 minutes prior to your appointment to allow time. We are also happy to mail them if there is adequate time prior to your intake to do so.
 
Please be advised, if your forms are not completed by the time your appointment is scheduled to begin, we will need to reschedule. Dr. Snider needs approximately 2 1/2 hours to do a thorough intake for evaluations and 1 1/2 hours for an initial counseling appointment. Please plan accordingly. 
 
Our forms were generated using Adobe Reader in PDF format.

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Serenity Neuropsychology & Counseling Health Screening FormPatient Psychologist Agreement Form

Serenity Neuropsychology & Counseling Health Screening FormRegistration Form

Serenity Neuropsychology & Counseling Health Screening FormHealth Screening Form

Serenity Neuropsychology & Counseling Client Psychologist Agreement FormTelehealth Informed Consent--Counseling Patients ONLY  

Serenity Neuropsychology & Counseling Patient Registration FormNotice of Privacy Practices-HIPAA

Notice to all patients: Complete the following Authorization/Release Form if you wish to have your records released to or obtained from anyone. If you have questions about releasing your records or about how to complete this form, we will be more than happy to assist you at your initial appointment. If you are being referred by a physician, please know your physician typically requests records be sent to them, particularly if you are being referred for psychological or neuropsychological testing.

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