childneuropsychologypc.com
Phone: 503-335-2223
Portland, Oregon
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before your first appointment

CONSENT FORMS

Consent for TELEHEALTH

Consent for Telehealth CONSULTATION

Consent for COMPREHENSIVE EVALUATION _IN-PERSON SERVICES

ADDITIONAL FORMS

Pre Appointment Health Survey

Pediatric Questionnaire

Notice of Privacy Practices

Acknowledgment of Privacy Practices


Nancy Loss, Ph.D.
Fredericka K. Hoeveler, Psy.D.

503-335-2223

2223 NE 47th Avenue
Portland, OR 97213-1911

  • home
  • about us
  • services
  • cogmed
  • forms
  • insurance
  • contact