Forms

PLEASE NOTE:

I AM CURRENTLY IN THE PROCESS OF UPDATING THIS FORMS PAGE. THE FORMS ON THIS PAGE ARE NOT THE CORRECT ONES.

PLEASE CONTACT MY OFFICE AND I WILL PROVIDE YOU WITH THE UPDATED FORMS. THANK YOU FOR YOUR UNDERSTANDING.

Notice of Privacy Practices may be found here. There is also a copy of this document in the waiting room.

The forms on this website are to be filled out by (or for) all new patients to this practice, even if you have had sessions(s) with Dr. Morris in the past.

For all patients to fill out:

1. Patient Information Form

2. Outpatient Services Contract

Additionally, for patients under 18 years of age, parent(s)/legal guardian(s) to fill out:

1. Child Therapy Contract

2. Brief Developmental History for Juveniles

If someone other than a minor's custodial parent or legal guardian (i.e. step-parent, grandparent) will be bringing the minor to therapy session, fill out:

1. Authorization to Release/Obtain Protected Health Information To/From a Non-Custodial Parent or Legal Guardian

If you (or your child) are, or have been, in psychological and/or psychiatric treatment, including mental health hospitals within the past 5 years, and would like Dr. Morris to obtain your medical records and be able to consult with these providers, please fill out:

1. Medical Record Release Authorization

Please bring completed paperwork, insurance card, and photo identification card to your first session.

816-407-9225
9 Victory Drive, Suite 1A, Liberty, MO 64068

close lightbox