Intake Forms
Each client will need to fill out the following intake paperwork before their first appointment:
(1) Client's Personal Data Intake Form (3 pages) - download here, print out, fill out and bring with you to your first appointment.
| intake_form_3_pages.doc |
(2) Maine Disclosure for Dick Conant (2 pages) - those clients coming to see Dick Conant, please click the download link just below, print out, read thoroughly, sign the 2nd page and bring with you to your first appointment.
| maine_disclosure_form_for_dick_2_pgs.doc |
(2) Maine Disclosure for Bev Conant (2 pages) - those clients coming to see Bev Conant, please click on the download link just below the graphic on the left, print out the form, read it thoroughly, sign the 2nd page and bring with you to your first appointment.
| maine_disclosure_bev.doc |
(3) Insurance Form (1 page) - please click on the download link just below the graphic on the left, print out the form, fill it out and bring it with you to your first appointment. We will also want a copy of your driver's license and insurance card.
| insurance_form_1pg.doc |