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Patient Forms

If you are having issues with the online paperwork, please contact our office and we will be happy to assist you.

All of your information will be submitted in a secure environment and in an encrypted format

Click “Online” next to your provider’s name to fill out and submit your forms electronically.  If you prefer, you can download the PDF file to print and bring to the clinic.  Please fill out the form as completely as possible to help us serve you.

Dr. Angela Chapman, M.D. Adult
Dr. Susan Shackelford, Ph.D. Adult   Kids
Dr. Timothy Cavell, Ph.D. Adult  Kids
Dr. Matthew Crouch, M.D. Kids
Dr. Meghan Murphy, Ph.D. Adult   Kids
Julie Council, LCSW Adult   Kids
Kamie Meeks, LCSW Adult   Kids
Kathy Jordan, LCSW Adult  Kids
Caroline Sawyer, LCSW Adult
Ananda E. Rosa, LCSW Adult
Courtney E. Goodrum, LCSW Adult   Kids
Ruth Wilkirson, LCSW Adult
Carol Cordell, LPC Adult    Kids
Chuck Shields, LPC Adult   Kids
Sarah C. Gheen, LPC Adult   Kids
Carrie Ann Reed, LPC Adult   Kids
Lee Walton, LPC Adult  Kids
Kristy Bailey, LPE Adult  Kids
Danell Will, LPC Adult  Kids
Tyler Allbright Adult  Kids

Existing patients can click the appropriate link below to complete the yearly financial update prior to the next scheduled appointment

The online forms include statements agreeing that you have read information about our privacy practices, informed consent, and patient responsibility. That information is located within the online forms as well as in the links listed below.  Please review each of these before filling out your forms.