Patient Forms

Listed below are forms for both neuropsychological testing and psychotherapy. Click on the appropriate form(s), print, and use your browser's "Back" button to return to this webpage.

Please bring all completed forms, signed where indicated, to your appointment. If you are unable to bring completed forms with you, please arrive at least 20 minutes early to complete the forms at that time.

In addition, be sure to bring health insurance card(s), and photo ID for adults. Contact our office if you have any questions. We look forward to seeing you.

Dr. Martinez: Neuropsychological Testing Forms for Adult and Child

Adult Patient Forms

Patient Information - Adult
Medical Release Authorization
Patient Privacy Notice
Patient Privacy Form

Child Patient Forms

Patient Information - Child
Child Background Information
Medical Release Authorization
Patient Privacy Notice
Patient Privacy Form

Drs. McBrayer: Psychotherapy / Counseling Forms

Demographics Form
Medical Release Authorization
Informed Consent - TeleMental Health

HIPPA Information, page 1
HIPPA Information, page 2
HIPPA Signature Form