Marion Rollings, PhD

For New Patients: If you are a new patient, please download and print these forms, fill them out, and bring them with you to your first appointment. Please understand that we must have your signed and completed paperwork before we can begin treatment.

Notice Of Privacy Practices For Protected Health Information
Policies and Procedures
Consent for Treatment (for Adults)
Minor Release for Treatment (for Children & Adolescents)
Client Initial Information
Patient Communication Preference
Cancellation Policy
Release Form
Informed Consent for the Release of Confidential Records

For New & Current Patients: If there is a health care provider, school, or other individual you would like me to speak with about you, please download and complete the Release Form to authorize me to speak with them. This release of information is revocable at anytime by you. For permission to communicate as allowable by law with your insurance company, please download and complete the Informed Consent form. This is consent is also revocable at anytime by you.

For Parent/Guardians of Child and Adolescent (minors) Patients: the Minor Release for Treatment form is required from both parents. If there are special circumstances where you believe this does not apply, please let me know of them.

U N D E R    C O N S T R U C T I O N-please bear with us as we work on this webpage.