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New Patient Intake Forms

New to our practice? Please take a moment to print and complete the new patient forms below and give them to your therapist at your intake session.

New Patient Informed Consent and Disclosure Statement

New Patient Intake Form

Release of Information Consent Form

Insurance Information Form

1919 Middle Country Road, Suite 308, Centereach, NY 11720

Phone: (631) 209-5343

email: [email protected]

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