Forms Medication Monitoring Form Allows you to rate your symptoms to help monitor medication response. Mood Chart This chart allows you to rate your mood each day. The pattern can help us find better treatments for you. Therapy Session Rating Let us know how therapy sessions are working for you with this form. Overall Life Rating This gives your therapist an overview of how each area of your life is going. New Patient Form All the information you’ll need to bring to your first visit (if under 18, use the Child & Adolescent Version). Insurance Verification Form You can send us your insurance information for online verification. Input from Friends and Relatives Two ratings which allow your friend or relative to share what they’ve seen in your moods. We also have a Child & Adolescent Version. Records Transfer to Our Office Use this form to transfer your records from other places of treatment to our office. Available as a pdf or MS-Word version. Records Transfer from Our Office If you are transferring care from our office, use this form to have a copy of your record sent to your new place of treatment. Available as a pdf or MS-Word version. Feedback & Suggestions Share your ideas to help make things better here.