CG Therapies

Forms

We look forward to meeting you.

Please bring these completed forms to your first session:

Click here to download: CG Therapies Intake Packet


Additional forms to complete if applicable:

Click here to download: Credit Card Authorization

Click here to download: Authorization to Release and Exchange Information

Click here to download: Notice of Privacy Practices (HIPAA Notice)

Click here to download: Childrens’ Privacy Fact Sheet


6033 N. Sheridan Rd. Suite 4, Chicago, IL 60660 • 773-359-3505info@cgtherapies.com