Client Forms

Please download the forms for the specific service, fill them out on your computer (or by hand), print them, and bring with you to your initial appointment.  Alternatively, a hard copy of the forms can be mailed to you to sign. (Please note that these forms may not download to your mobile device).

First, please complete a separate release form for each individual from whom we can request information (e.g., teachers, therapists, physicians) and/or to whom we can release results of the evaluation or treatment.  Additionally, please complete the Constant Contact release form to receive information about upcoming events (e.g., presentations), clinical service offerings, and noteworthy discussion of articles regarding behavioral health, neuropsychology, psychotherapy, education, and other relevant issues.

Then, please select the provider you will be seeing at PNC below, then the type of service you are interested in, and fill out all of the forms under that service.

 

Release Forms

Constant Contact Email Release Form

PNC Release Form – Dr. Rubin

PNC Release Form – Dr. Cook

 

Select a Provider: