COVID-19 - We are providing Telehealth as an alternative during this period.

Inspire Therapeutic Services, LLC
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    • Home
    • Contact Us
    • About Us
    • Client Log In
    • Billing
    • Specialties
    • Insurance & rates
    • Forms
    • Adults
    • Individual Therapy
    • Couples Therapy
    • family therapy
    • Children & Adolescent
Inspire Therapeutic Services, LLC
  • Home
  • Contact Us
  • About Us
  • Client Log In
  • Billing
  • Specialties
  • Insurance & rates
  • Forms
  • Adults
  • Individual Therapy
  • Couples Therapy
  • family therapy
  • Children & Adolescent

Clients Forms

New-Registration-Form (pdf)Download
New Registration Form (Cont.) (pdf)Download
HIPAA Notice of Practices (pdf)Download
Outpatient Service Agreement Rev. 09.2020 (pdf)Download
Authorization for Credit Debit Card Payment (pdf)Download
Parent Authorization for Minor’s Mental Health Treatment (pdf)Download
EAP-New-Registration (pdf)Download
Covid-19-Liability-Release-Waiver (pdf)Download
Authorization to Release Information (pdf)Download
GAD-7_Anxiety-updated_0 (pdf)Download
Patient Health Questionnaire PHQ9_id_date_08.03 (pdf)Download

Medical Record Copy Fees

There is a $25.00 fee for Medical Records

Formas en Español / Spanish Forms

Prácticas de Privacidad (pdf)Download
Hoja de Registro de Nuevo Paciente (pdf)Download
Acuerdo de Tratamiento Rev 09.2020 (pdf)Download

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