New Patient Forms & Information

To make the best use of our time during your initial visit, please print out the New Patient Intake Forms, then select and print the appropriate Intake Questionnaire Form(s), fill out and sign them as needed. You may email them to RStoutEAP@aol.com

We will need a copy of your Driver's License and both sides of your Insurance Card. Please send by email or text.

Please make a note of your appointment date and time. Remember, this time is reserved just for you, so if you must reschedule or cancel an appointment, kindly give us 24 hour notice.

We look forward to meeting with you!

New Patient Registration Forms       pdf New Patient Intake Questionnaire       *Adult pdf       *Child/Adolescent pdf