Forms used by Dr Melody Snider Serenity Neuropsychology and Counseling - Idaho Serenity Neuropsychology & Counseling

If you are unable to print and complete the required forms prior to your appointment, you will need to complete them at our office. Please arrive a minimum of 75 minutes prior to your appointment to allow time to complete the forms.

Please be advised if you do not arrive in time to complete your forms prior to your scheduled appointment, we will need to reschedule. Dr. Snider needs approximately 90-120 minutes to do a thorough intake. Please plan accordingly.

In the event we need to reschedule your first appointment, please know there is typically a 3-4 week waiting period before we can reschedule your initial appointment.

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Please complete each of the following 4 forms. Be thorough as this information is necessary to provide an appropriate evaluation and follow up treatment.

(Forms will open in new window)
Client-Psychologist Agreement Form

Notice of Privacy Practices

Client Registration Form

Health Screening Form

COVID-19 Informed Consent for In Person Treatment

Notice to all clients: Complete the following Authorization/Release Form if you wish to have your records released to or obtained from anyone. If you have questions about releasing your records or about how to complete this form, we will be more than happy to assist you at your initial appointment. If you are being referred by a physician, please know your physician typically requests records be sent to them, particularly if you are being referred for psychological or neuropsychological testing.

Authorization/Release Form

Serenity Neuropsychology, PLLC

Melody Snider, PhD