Forms & Policies 

Intake Forms 


  • Please note that the Health History, Global Consent and Contact Sheet are required before the first appointment can be scheduled

  • The necessity to engage in individual therapy while also engage in medication management services will be discussed individually

  • The Release(s) of Information can be completed at your first appointment

  • Releases of Information are important in helping to coordinate your care; at a minimum they are required for PCP and individual therapist but may also be necessary for school(s), specialists and family members

  • Please also note: I am not able to complete forms or letters for emotional support animals 

© 2018 by Jennifer M. Shuart, LICSW, PMHNP-BC, APRN. Proudly created with