Forms to Complete for Adult Therapy

Please complete the required fields, and click to submit, on the document below in order to setup a patient account. Upon receipt of your completed form, we will contact you with an appointment if we have an opening at the time your application is processed. If you do not hear from us, it means that we were unable to find an appropriate appointment, and we do recommend continuing your search for a provider.

During the first 30 days, appointments are given based on a ‘first come, first serve’ basis by the date your documents are received. After 30 days, we recommend that you call our office regularly to check for openings. Barring any insurance or treatment issues, those who contact us and have an intake on file longer than 30 days will be placed in an opening if one is available at the time of their call. Additional forms may be requested at the time of placement with a therapist.

Beachside Intake & Medical History

If you need help, please contact us. We are happy to provide any further assistance you may need, and we look forward to seeing you at Beachside Adult & Family Therapy.