For your convenience, you may complete the below forms electronically, or print them out and complete by hand. Subsequently, please return your form(s) to our office in person, via email at info@therapydallas.com, or via fax at 214-481-2851.

For Children/Adolescents:

• New Patient Packet – Child
• Contact and Family Information
• Authorization to Release Information
• Email Authorization
• HIPAA Privacy Notice

For Adults:

• New Patient Packet – Adult
• Contact and Family Information
• Authorization to Release Information
• Email Authorization
• HIPAA Privacy Notice