If you are a new client or a returning client whose information has changed, please complete the forms below. You can complete them online or email the completed PDF form to
s-rosenbloom@northwestern.edu
New Client Online Form
This online form includes all the required client information and consent forms.
| New Client Online Form | Online Form → |
Individual Forms
These individual forms are only necessary if you did not complete the new client online form above, and need to submit a specific form.
| Client Information Form | Online Form | Download PDF Form |
| Informed Consent for Telepsychology | Online Form | |
| Psychotherapy Contract | Online Form | Download PDF Form |
| Informed Consent and Signed Authorizations | Online Form | Download PDF Form |
| HIPAA Policy (for viewing only, no submission required) | Download PDF Form |