Please download the forms below, fill them out, and bring them to your first visit. If you have questions please don't hesitate to contact Dr. Berquist.
| Client Service Agreement.pdf |
| Client Service Agreement Signed Page.pdf |
| Privacy Policy.pdf |
| Verification of Privacy Policy.pdf |
| Registration Form.pdf |
| Video Release Form.pdf |
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Please download the authorization form and fill it out if you have someone you would like Dr. Berquist to speak with regarding your child's care.
| Authorization to Release Information to Others.pdf |
Please download this form and fill it out if you would like to receive information from Dr. Berquist via non-secured media. Please discuss with Dr. Berquist for more details if interested.
| Consent for Nonsecure Communications.pdf |
Please download this form and fill it out if you would like to pay via electronic means (Zelle Pay, Cash App, Venmo, Paypal.me). Please discuss with Dr. Berquist for more details if interested.
| Electronic Payment Communications Disclosure.pdf |
Please download this form and fill it out if we discussed your desire for telehealth sessions (telephone or video conference sessions) or please discuss with Dr. Berquist for more details if you are interested.
| Telehealth Consent Form.pdf |