Forms

 Please read and complete the forms listed below before our first meeting. This information will make our first few meetings more productive and will help to create a plan for treatment that is right for you. If there are any questions on these forms that you do not feel comfortable answering, please do not feel obligated to do so.

For adults, please print and complete the Adult packet. For children (under 18 years of age), please print and complete the Child packet.  

The Authorization for Release of Information form can be used to provide written permission for Dr. Septimus to communicate about your care to a person or organization that you choose (i.e. school or doctor).