Completing the Intake Form
Please complete, sign, and submit an age-appropriate intake form (see below). Our clinic director Dr. Knutson will review your completed form, and we will contact you. If you do not hear from us within 2 business days, or if you have any questions, please call us at 617-876-9099.
Instructions for completing the form:
1. Download the appropriate form.
2. Save the form to your desktop, then open the form from your desktop with Adobe Reader. Mac users should use Preview.
3. Fill in your name, save and close the form, then reopen the form from your desktop. Make sure your name saved to the form. (You could lose all your data if the form doesn't save properly!)
4. Complete the form.
4. Save your completed form and send it to us as an attachment through the secure web form at the bottom of this page.
5. If you need more space to answer some of the questions, use the Extra Attachment Form.
6. If you have any trouble, please call us at 617-876-9099.
(Alternatively, you can also print out a blank form, fill it out by hand, and mail it to us.)
Instructions for completing the form:
1. Download the appropriate form.
2. Save the form to your desktop, then open the form from your desktop with Adobe Reader. Mac users should use Preview.
3. Fill in your name, save and close the form, then reopen the form from your desktop. Make sure your name saved to the form. (You could lose all your data if the form doesn't save properly!)
4. Complete the form.
4. Save your completed form and send it to us as an attachment through the secure web form at the bottom of this page.
5. If you need more space to answer some of the questions, use the Extra Attachment Form.
6. If you have any trouble, please call us at 617-876-9099.
(Alternatively, you can also print out a blank form, fill it out by hand, and mail it to us.)
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Secure Encrypted Web Form
* Required fields. Remember to SAVE your completed form before sending!