info@behavioralhealthny.com | (212) 722-3434
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Make an Appointment: info@behavioralhealthny.com | (212) 722-3434
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(212) 722-3434
info@behavioralhealthny.com

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    • Anxiety
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    • Panic Attacks
    • Phobias
    • PTSD
    • Job Stress
  • CBT
  • Psych Testing
  • Getting Started
    • Rates & Insurance
    • Forms
    • Appointment Request
    • Privacy & Policy
  • Contact
Close menu
  • Home
  • Our Team
  • Conditions Treated
    • Anxiety
    • Depression
    • Relationship Issues
    • Couples Therapy
    • Child Therapy
    • Social Anxiety
    • ADHD
    • OCD
    • Panic Attacks
    • Phobias
    • PTSD
    • Job Stress
  • CBT
  • Psych Testing
  • Getting Started
    • Rates & Insurance
    • Forms
    • Appointment Request
    • Privacy & Policy
  • Contact
(212) 722-3434

info@behavioralhealthny.com

Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.

 

Contact Us

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Behavioral Health of New York

125 East 84th Street #1C
New York, NY 10028
(212) 722-3434

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