Sweeney Dawley Recovery Center, LLC.

Mental Health Medication Management

Sweeney Dawley Recovery Center, LLC.

Mental Health Medication Management

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Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session:
New Patient Form, Notice of Privacy Practices Acknowledgment Form

New Patient Form

Notice of Privacy Practices Acknowledgment Form

Read our Notice of Privacy here ➜

Informed Consent for Telehealth

Consent to receive Correspondence From Sweeney Dawley Recovery Center

Credit Card Authorization Agreement

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information:
Authorization for the Release and/or Discussion of Protected Health Information

Protected Health Information