THe providers at

 

East Quaker

Intake Paperwork

 

Please contact your provider prior to completing paperwork. Some providers use alternate paperwork.

 

Please bring paperwork to your initial session.

Adult Intake Questionnaire

 

Child / Adolescent Clinical Questionnaire

 

Patient Information Sheet

 

Signature Packet


Professional Services Agreement

 

HIPPA

 

 

 

 

 

 

 

 

 

 

 

 

 

All are Welcome

 

The diverse providers who practice at East Quaker are committed to supporting you towards positive change, peace and contentment.

 

 Insurances Accepted

 

Blue Cross Blue Shield

Independent Health

Univera

 

 providers are available for both in-person

and telehealth options