Patient Registration

New Therapy Patient Registration

Thank you for choosing to register online. Please do so only after you have spoken to Dr. Thorpe and an appointment has been set for you.

When you click on the link at the bottom of this page, to start the Registration process, you will be presented with a form where you can type in your contact and insurance information. Please enter in as much information as you can and not just what is highlighted. Cell phone and e-mail are necessary so we may reach you.

For parents or couples counseling, make sure to enter this contact information as well. Begin by putting a check mark in “Additional Client” or “Partner Information” and the window to enter this information will open.

If you are using in-network benefits or if you want us to bill your insurance carrier as a courtesy, please enter this information. We will also take a copy of your insurance card when you come in, so please have this ready at the appointment.

Providing this information prior to coming in to our office for your initial meeting, helps us save you time when you come in and eliminates errors in entering your information in to our system. The security and privacy of the information you provide are of utmost importance to us. Upon completing the online form and saving the information by clicking on the “Save” button, you will be able to print our Intake forms if you like. It is especially helpful if you print out the Registration Form and bring this to your appointment, so your contact information is handy.

Therapist-Patient Agreement: Please read this document and if you are coming with another family member, have them look at it as well. It is not necessary to print this form out.  We will go over it in detail and obtain a signature at the start of the appointment.

Authorization for Release Form: Only fill out this form if you would like our office to send clinical information to your primary care physician, psychiatrist, or any other professional involved in your care that you would like notified.

New Jersey Notice: Please read.

 

Please Click Here to Start the Registration Process