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Alliance for Healing PA
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    • Home
    • Services
      • Therapy Services
      • Mental Health Therapy
      • Neurofeedback
      • Sex Addiction Therapy
      • Anxiety Therapists
    • About
      • About Us
      • Staff
      • Join Our Team
      • FAQS
    • Therapy Resources
      • Insights
      • Phototherapy Cards
      • Princess Sophia's Gifts
      • SASH 2021 Presentation
    • Patient Forms
    • Contact
    • COVID-19 Updates
Alliance for Healing PA

Signed in as:

filler@godaddy.com

  • Home
  • Services
  • About
  • Therapy Resources
  • Patient Forms
  • Contact
  • COVID-19 Updates

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Client Forms

Please download the appropriate form and complete it with black or blue ink. 

You may email it back to us at admin@aheartt.com, or fax it to us at 651-493-9335.

Alliance for Healing Release of Information (pdf)Download
Safe Harbor Agreement (pdf)Download
Telehealth Consent Form (pdf)Download

Neurofeedback Forms

Download the Neurofeedback Assessment form and fill out the symptoms you are experiencing following your session. Each symptom you experience, you will want to rate them from 1-10 with 10 being the worst. 

Symptom Tracking for NFB (pdf)

Download
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Alliance for Healing

4505 White Bear Pkwy, Suite 1500, White Bear Lake, MN 55110, US

(651) 493-8150

 COPYRIGHT © 2022 ALLIANCE FOR HEALING - ALL RIGHTS RESERVED

Last Updated 03/2022 | Fax: (651) 493-9335

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