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Western Reserve Psychological Associates, Inc.Empowering change for over 40 years

form fillingIntake Forms

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.

Fill them out at least 24 hours before your first appointment.

To access our patient portal, please contact our office with your email address and request a welcome email. Click the link in the shaded box of the welcome email you received. You will be asked to create your own password-protected account on the portal.

If the patient is under the age of 18, you will need to complete the following forms:

If the patient is 18 years of age or older, you will need to complete the following forms:

If you are between the ages of 18 and 26 and are using your parents’ insurance, you will also need to complete this form for billing purposes only:

If you will be seen for couples counseling, family therapy or group therapy, please also complete:

Once you have established your account in Updox, you may access it at any time with this link: