Forms

Child Intake

intakechild2016.pdf
  • Parents, please complete and sign this form for your minor child(ren).

Adult Intake

intakeadult2016.pdf
  • Clients aged 18 and older, please complete and sign this form.

Informed Consent for Therapy

informed_consent-general.pdf
  • A signature on the last page of this form is required for all clients. Adult clients and parents
    of minor children, please review the form and sign it.
  • IMPORTANT: For divorced or separated parents, who share joint legal custody of minor child(ren),
    signatures are required by BOTH parents before Dr. Santoro will meet with your child(ren).

HIPAA Notice

hipaa_notice_of_privacy_practices.pdf
  • A signature on the last page of this form is required for all clients. Adult clients and parents of
    minor children, please review the form and sign it.

Professional Disclosure Statement

cm_prof_disc_stmt.pdf