
3400 South Park Road, Office 9
Bethel Park, PA 15102
(412)-368-3443

Policies and Forms
Informed Consent Ages 13 and Under
Informed Consent Ages 14-17
Informed Consent for Adults
HIPPA- Notice of Privacy Practices Policy
Social Media Policy
Release to Contact PCP
Authorization for Release of Mental Health
Information
Credit Card Authorization Form
Fee Agreement and Financial
Policy