OrensteinSolutions

Welcome to Our Private Practice.

Downloadable Forms

Dr. Susan Orenstein

• New Client Data Form and Client Agreement/HIPAA (.pdf)
  These forms are to be completed by all new patients regardless of age.
• Adult Questionnaire (.pdf)
  These forms are to be completed by all new patients age 18 and over.
  

• Authorization Form (.pdf)
  Complete this form if you have records from another provider you would like to have sent to us
  

Dr. Eve Fontaine

Information for your first visit with Dr. Eve Fontaine:

• New Client Data Form and Client Agreement/HIPAA (.pdf)
  These forms are to be completed by all new patients regardless of age.
• Adult Questionnaire (.pdf)
  These forms are to be completed by all new patients age 18 and over.
  
• Child/Teen Questionnaire (.pdf)
  These forms are to be completed by all new patients under age 18, and signed by both parents.

Additional Forms for Dr. Eve Fontaine:

• Authorization Form (.pdf)
  Complete this form if you have records from another provider you would like to have sent to us

Dr. Murray McNiel

• New Client Data Form and Client Agreement/HIPAA (.pdf)
  These forms are to be completed by all new patients.
• Adult Questionnaire (.pdf)
  These forms are to be completed by all new patients.
  

• Authorization Form (.pdf)
  Complete this form if you have records from another provider you would like to have sent to us.

Dr. Julia Messer

• New Client Data Form and Client Agreement/HIPAA (.pdf)
  These forms are to be completed by all new patients.
• Adult Questionnaire (.pdf)
  These forms are to be completed by all new patients.
  
• Teen Questionnaire (.pdf)
  These forms are to be completed by all new patients under age 18, and signed by both parents.

• Authorization Form (.pdf)
  Complete this form if you have records from another provider you would like to have sent to us
• Consent Form Defense (.pdf)
• Consent Form Evaluation (.pdf)
• Anger Management Registration and Informed-Consent Forms (.pdf)
  

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