top of page

Paperwork

Tyler Psychological Services Intake Packet
Telehealth Emergency Contact Form
Telehealth Informed Consent
In-Person Initial Screening Form
Consent for Returning to In-Person
In-Person Screening Questions

This form is to be completed 15 minutes prior to each in-person session. 

Have you knowingly come into contact with someone with COVID-19 in the past 72 hours?
Are you awaiting the results of a COVID test or have had a positive COVID test in the past 72 hours?
Have you or anyone in your household experienced any of the following symptoms: fever, chills, sore throat, cough, chest congestion, nausea, shortness of breath, or loss of smell in the past 72 hours?
Have you travelled to a CDC specified hot zone in the past 10 days?

Thank you for submitting.  The form has been received and will be reviewed by your therapist before your session. 

bottom of page