Patient Form Instructions: Please download and completely fill out forms 1-5 prior to attending your first appointment with all providers other than Dr. Dexter. If you are seeing Dr. Dexter please complete the Child-Adolescent Questionnaire prior to your first appointment.  If you are seeing Connie Chapman for couple's therapy, please complete the Couples Disclosure Form in addition to forms 1 - 5 for each member of the couple.

Please bring the completed forms and your insurance card with you to your first appointment and remember to arrive at least 10 minutes early.

Please note our cancellation policy: we require 24 hours notice of any appointment cancellation. If the initial appointment is cancelled less than 24 hours before the appointment, we will be unable to reschedule any future appointments with you in our office. Please feel free to contact us with any questions you may have during office hours or leave a message after hours: 509-458-5889.

ALL NEW PATIENTS MUST COMPLETE AND SIGN THE FOLLOWING FORMS:

1. Adult Patient Registration Form 
    OR
    Minor Patient Registration Form
2. Notice to Our Patients
3. Patient History Form
4. Patient Problem Survey
5. Notice of Privacy Practices Acknowledgement

ALL NEW PATIENTS MUST READ THE FOLLOWING:

Notice of Privacy Practices

THE FOLLOWING ARE FOR YOUR INFORMATION ONLY:

Maps and Directions
Red Flag Rules

If you are seeing a therapist, please complete the Client Disclosure Statement with Therapist in addition to forms 1 - 5.  

Client Disclosure Statement with Therapist

If you are seeing Dr. Dexter, please complete the following form.
 
Child and Adolescent Questionnaire

If you are seeing Connie Chapman for couples therapy, please complete the following form.

Couples Disclosure

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