Client Forms
For Consultations:
If you’re visiting us for a consultation soon to see how neurofeedback might be able to help, our time with you in that meeting will be much more productive if we have some paperwork from you in advance.
You’re welcome to either fill out your paperwork online or you may download the forms (which are in PDF format) and fill them out in advance by hand. Online forms are private, secure and HIPAA-compliant.
Online Forms for Adults
Adult General information
Adult Checklist
Adverse Childhood Events Questionnaire (optional)
Online Forms for Children
Child General information
Child Checklist
Adverse Childhood Events Questionnaire (optional)
Download and Print Forms
Use the forms below only if you do not wish to submit your paperwork online, but would rather print it out and complete it by hand.
Download and Print Forms for Adults
Download and Print Forms for Children
For qEEG Clients:
If you will be having a qEEG brain map, we recommend you read the brain mapping instructions found below at least 24 hours in advance of your appointment so you can be properly prepared and know what to expect.