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To Make an Appointment

If you would like to make an appointment, please call our office at 502-327-4622. If you have already scheduled an appointment, you can help expedite the intake process by completing the forms in the list below. Please download and print the forms, complete and sign them, and bring them with you along with your insurance card. Please arrive about 15 minutes prior to your first appointment.

Intake Form (Adult)
Intake Form (Child / Adolescent)
Samaritan Fund Scholarship Application
Getting Acquainted Information and Disclosure Form
Financial Agreement
Credit Card Authorization Form
HIPAA Notice

Also, if you are one of our current clients, please consider printing and submitting the following Client Satisfaction Survey:


 
We must learn to regard people less in light of what they do or omit to do, and more in the light of what they suffer.
– Dietrich Bonhoeffer –
 
Make an Appointment