Judy Fisher, MSW, LCSW
New Patient Forms

Please print these forms and bring them with you to your first appointment.

If you don't have a printer, no problem! Come 15 minutes early to your appointment. We have plenty of copies at the office for you to fill out.

Use your computer's back button when you've finished printing each page.

Patient Registration	Insured/Responsible Party Information	Permission to Treat
Cancellation Policy Receipt	Notice of Privacy Practices	Notice of Privacy Practices Receipt

 

For Patient Privacy, Ms. Fisher has a separate phone line:
(919) 644-0804