Dr Morris Phycholigy
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            • External link opens in new tab or window816-407-9225
            • External link opens in new tab or window9 Victory Drive, Suite 1A, Liberty, MO 64068

            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 External link opens in new tab or windowhere.  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. External link opens in new tab or windowPatient Information Form

            2. External link opens in new tab or windowOutpatient Services Contract

             

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

            1. External link opens in new tab or windowChild Therapy Contract

            2. External link opens in new tab or windowBrief 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. External link opens in new tab or windowAuthorization 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. External link opens in new tab or windowMedical Record Release Authorization

             

             

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

             

             

             


            • External link opens in new tab or window816-407-9225
            • External link opens in new tab or window9 Victory Drive, Suite 1A, Liberty, MO 64068
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