New Client Documents

Psychologically Speaking with Dr. Jack Singer, LLC

Please read these HIPPA forms and if you have no questions, please sign the signature page and fax it to me, along with the forms you fill out below (either the minor or adult forms). Thank you.

New Client Information Sheets Adults

New Client Information Sheets Minors

Instructions:

  1. Print form (2 pages)
  2. Fill in information
  3. Bring to first appointment with Dr. Jack Singer OR
  4. Fax to 949-481-5057 if your appointment is a phone consultation

Driving directions and map

Contact Dr. Jack Singer

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