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




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



 providers are available for both in-person

and telehealth options