Intake Forms

1) Notice of Privacy Practices

2) Consent to use and disclose Health Information

3)Teletherapy Consent

4)Client Information Form

5)Psychologist-Patient Tx agreement

6)Child Therapy Contract

7)Authorization to Release PHI

8)Adolescent therapy contract

9)Checklist of Concerns

10)Child Checklist of Characteristics

  • (207) 420-1386
  • apg@aprasadgaur.com
  • 1829 E Franklin St, #100d Chapel Hill, NC 27514

"Serving Chapel Hill, Carrboro, Durham, Pittsboro, and surrounding areas within Orange and Wake Counties in North Carolina."

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