Intake forms need to be completed by each new client at Western Reserve Psychological Associates, Inc., as well as former clients who are returning to the practice after a six month or longer absence.
To save you time, you may print the forms on this page---Adult Intake Form or Child/Adolescent (under 18 years old) Intake Form.
Fill them out before you come for your first appointment.
For your convenience, the forms are supplied here in two formats: PDF (portable document format) and DOC (Microsoft Word).
If you have the Microsoft Word program, you can use the DOC versions.
PDF can be viewed and printed with the free Adobe Acrobat Reader (plug-in). The acrobat Reader is easy to download and install.
Adult Intake Form:
Child/Adolescent Intake Form:
Food Diary Form:
Information Release Authorization Form: