Intake Paperwork

Adult Client 18 Years or Older

• HMCTI Intake Assessment
• HMCTI Philosophy & Financial Information
• HMCTI HIPPA Disclosure
• HMCTI PCP Release of Information
• HMCTI Release of Information
• HMCTI Mandatory Disclosure
• HMCTI Attestation of Medical Decision Making

Children 17 Years & Younger Additional Form (if applicable)

• HMCTI Activity Release
• HMCTI Attestation of Medical Decision Making