New Patient Paperwork

Please complete and submit both required forms at least 24hrs prior to your first appointment. This will help ensure a smooth and efficient visit. If you have any questions regarding the forms or the submission process, please feel free to reach out for assistance.

Please submit all forms to : chelseasckbtg@gmail.com

Thank you for your cooperation.

The Pediatric Client History Packet is designed to collect comprehensive background information essential for our clinicians. It includes details such as personal and family medical histories, developmental milestones, and relevant behavioral observations. Additionally, the packet gathers information about the child's primary care physician (PCP), including contact details and any existing medical diagnoses.

This information is crucial, as it may be used for insurance authorizations and claims, depending on your child’s insurance coverage. Ensuring this packet is complete and accurate will facilitate a smoother process in receiving the necessary services for your child.

Our New Patient Policies Packet outlines the most current clinic policies, procedures, payment information, and consent forms for treatment, including those related to HIPAA and the release of information. We encourage you to read through the packet carefully to gain a comprehensive understanding of all of our detailed policies.

Please note that having a card on file is mandatory in accordance with our policies.

Additionally, we request that parents submit a copy of the patient’s insurance card(s) and a parent’s photo ID.