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New Client Intake Forms

New Client intake forms may be found and submitted here or by emailing intake@fmhcofnny.com

New Client Intake Forms

Please complete the following questionnaires and agreement forms and use the drop box to submit all paperwork. Failure to complete all forms in their entirety 24 hours prior to your appointment may result in your appointment being cancelled. 

Initial Intake Questionnaire

HIPAA Agreement form

Consent for Treatment and Treatment Limitations

Fee Agreement

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