You can save time during your first office visit by printing, filling out, and signing the forms below. Not all forms are required for every patient, so please read the description to know if it is required for your type of treatment.
Information & Consent for Treatment Form
Required for all new patients
Confidential Adult Patient Information Form
Required for new patients seeking individual and/or couples therapy
Confidential Adolescent Patient Information Form
Required for new adolescent patients
HIPPA Form
Required for all new patients
Consent to Release Confidential Information Form
Only required to release a patient’s confidential records
Authorization to Pay by Credit Card
Not required
I work with adolescents, adults, and couples.
Learn how I can help you with issues or gain deeper understanding of yourself.
Learn about my practice & request an appointment:
Nora Taylor, PsyD | Licensed Clinical Psychologist | PSY27442
Email: norataylorpsyd@gmail.com | Phone: 424.262.3512
1820 S. Catalina Ave. #105, Redondo Beach, CA 90277
© Nora Taylor, PsyD, 2021 • Website design by Molly Suber Thorpe