Forms
PLEASE NOTE: The information on this page applies ONLY to those who have already scheduled an appointment with Dr. Mattox. If you have not yet scheduled an appointment, please call the office. Dr. Mattox will tell you at the time of scheduling what paperwork will be required.
If you need Dr. Mattox to release information to any other entity (school, physician, other treatment provider, etc.) or want to give permission for Dr. Mattox to speak to any other person about the patient, please complete the following form:
Authorization to Release Client Information
If you wish to have a remote (virtual) telepsychology session, the following form is required to be completed and on file. Please understand that Dr. Mattox will decide whether a telepsychology session is appropriate for what you are requesting.
Telepsychology Informed Consent
If you have previously provided information that has now changed, please use one of the following forms to update your information. Please note these are NOT needed for new patients:
Updated Contact and Insurance Information – Adult Client
Updated Contact and Insurance Information – Child/Adolescent Client