New Clients

Intake Form

1

Client Intake Questionnaire

Prior to your first visit, please complete the following Client Intake Questionnaire. Please allow yourself sufficient time to complete. It is recommended that you use a public computer when completing this form. Download the form, fill it out electronically, and email it to Dr. Martin.

Do not email sensitive personal information. Send completed forms to: [email protected]

ClientIntakeForm (doc)
2

Office Forms

In addition, please take the time to review the following three forms. You are welcome to print and sign where applicable and bring with you to your first visit. Forms will also be available in our office for signature.

CA Office Policy & Consent 2017 (doc)
Download
CA Office Release of Information 2010 (doc)
Download
CA Privacy Policy 2017 (doc)
Download