Gale and Associates

Center for Assessment and Psychotherapy

Call Us: 435-645-9240

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    • Max Gale, Psy.D.
    • Jennifer Gale, Psy.D.
    • Sari Soutor, Ph.D.
    • W. Wesley Walker III, MA, LPC-S
    • Kirandeep Kaur, Ph.D.
    • Michal Johnson Ph.D.
    • Davina Hardman, Admin
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Home / Individual Therapy New Patient Forms for Dr. Max Gale

Individual Therapy New Patient Forms for Dr. Max Gale

PLEASE COMPLETE THE FOLLOWING FORMS AND BRING TO YOUR FIRST SESSION:
  • Therapy Intake Form
  • Outpatient Services Contract
  • Financial Policies
  • HIPAA Notice of Privacy Practices
PLEASE COMPLETE THESE FORMS IF YOU ARE COMPLETING THEM FOR A MINOR:
  • Therapy Intake Form – MINOR
  • Outpatient Services Contract – MINOR
  • Outpatient Services Contract
  • HIPAA Notice of Privacy Practices

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