Instructions for Completing Forms your initial appointment.
Please print out and
complete the necessary forms. Remember to bring the completed forms to your
initial appointment. They are to be signed, dated and witnessed at the time of
your initial appointment.
Adult Intake Form
Privacy of Health Records Form (HIPPA)
Consent to Treatment Form
If you are the parent or legal
guardian of a child or adolescent (age 5- 17) who will be a
client of Dr. Susan Hughes May & Associates, Inc. please
click, print, and complete these forms:
Child and Adolescent Intake Form
Privacy of Health Records Form (HIPPA)
Consent to Treatment Form
Teacher's Academy Survey
(If
your child has been experiencing school or learning
challenges please have your child’s teacher complete this
form and bring it with you to the initial appointment.)