If you're a new client, please complete the following forms and bring them to your first therapy session. If you are interested in telepsychology, please email [email protected] (HIPAA compliant email) with your insurance card, date of birth, new patient intake forms as well as informed consent for telepsychology. Dr. Soliman will determine if the referral is an appropriate fit for telepsychology via email. 


“No one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income.”

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Helpful Forms

Adult Intake Packet 

Adult Intake Packet- Spanish 

Permission to Exchange Info (ROI)

COVID-19 Consent 

Informed Consent for Telepsychology

HIPAA NPP Form

Insurance Acknowledgement 

No Surprise Act/ Good Faith Estimate (Private Pay Only)

Child Intake Packet  

Couples Therapy Intake 

Couples Therapy Consent

Couples Therapy Intake- Spanish

Couples Therapy Consent- Spanish 

Family Intake Form 

Family Intake Form- Spanish