Wanting to become a new patient on our waitlist?
Fill out this form below to give us your information. We will then contact you when we have paired you with one of our providers.
If you have not heard from us in 6 weeks for therapy/3 months for testing, please give our office a call at (608)-348-4060
Have you been accepted as a patient?
We encourage our patients to fill out some paperwork prior to their intake appointment, please see these forms attached below. When completed, print them out and bring them to your first appointment with us.
The Information Sheet and Service Contact provides our staff with your official contact information and provides the staff with accurate billing information
The Personal Assessment provides the therapists with an accurate representation of your assessment of your current situation
The Patient Bill of Rights informs the clients of their rights as a client- you do not need to print this form, it is just here for your convenience
The Social Media Policy explains that clients are not allowed to friend PFRC staff on any form of social media
The Admission and Consent to Treatment Agreement has information that is vital for our clients to read through including information about billing
The Informed Consent for Telepsychology is a consent form for use when one is unable to attend in person sessions
The Admission Document Checklist is a review of all of the documents a New Client should receive at their initial appointment