VERMONT CENTER FOR ANXIETY CARE
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  • Vermont Center for Anxiety Care
    • About the Vermont Center for Anxiety Care
    • Our Therapists
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    • Continuing Education
  • New Client Intake Forms
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  • Dr. Paul Foxman
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Additional Intake Forms -
Malaika Darnell-Martin

Adult Intake Forms

Adult Intake Form
Billing and registration Form
Patient Policy Form
Patient Privacy Notice
Patient Privacy Acknowledgement
Teletherapy Consent Form
Professional Disclosure
Billing Update
Credit Card Form

​Child & Adolescent Intake Forms

Child and Adolescent Intake Form
Child Information and developmental history
Billing and registration form
patient policy form
patient privacy notice
patient privacy acknowledgement
teletherapy consent form
professional disclosure
Billing Update
credit card form
Vermont Center for Anxiety Care (Affiliated with Otter Creek Associates) • 112 Lake St., Burlington, VT 05401 • Tel: 802-865-3450 ext. 480 • Fax: 802-859-3309
  • Home
  • Vermont Center for Anxiety Care
    • About the Vermont Center for Anxiety Care
    • Our Therapists
    • Professional Opportunities
    • Continuing Education
  • New Client Intake Forms
  • Books and Products
  • Dr. Paul Foxman
  • Speaking Engagements
    • Upcoming Speaking Engagements
    • Workshop Topics
    • Testimonials
  • Contact