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Patient Tools

All of your information will be submitted in a secure environment and in an encrypted format

Click Online next to your provider’s name to fill out and submit your forms electronically.  If you prefer, you can download the PDF file to print and bring to the clinic.  Please fill out the form as completely as possible to help us serve you and your child.

Dr. Matthew Crouch, M.D. Online   PDF
Dr. Susan Shackelford, Ph.D. Online   PDF
Dr. Timothy Cavell, Ph.D.  Online   PDF
Julie Council, LCSW Online   PDF
Kathy Jordan, LCSW Online   PDF
Kamie Meeks, LCSW Online   PDF
Caroline Sawyer, LCSW Online   PDF
Courtney E. Goodrum, LCSW Online   PDF
Carol Cordell, LPC Online   PDF
Chuck Shields, LPC Online   PDF
Sarah C. Gheen, LPC Online   PDF
Carrie Ann Reed, LPC Online   PDF
Kristy Bailey, LPE Online   PDF
Teen Challenge Students Online   PDF

Existing patients can save time by clicking the appropriate link below to complete the yearly financial update prior to the next scheduled appointment

The online forms include a statement agreeing that you have read information about our privacy practices, informed consent, and patient responsibility. That information is located within the online forms as well as in the links listed below.  Please click through each link and read it prior to completing your forms.