Because some topics are hard to bring up, we ask these same questions of everyone.
High Risk Activities
Please indicate if you’ve ever done any of these activities, how often, and whether it’s happening now or happened in the past.
Developmental and Educational Information
Must be filled out for all children and teens.
Please complete if you are a young adult (up to age 25) who has ever been diagnosed with ADHD, a learning difference, Asperger’s, sensory processing disorders, or any issue impacting your ability to make it through school easily and/or make friends.
Notice of Privacy Practices HIPAA Acknowledgement/Consent
I hereby acknowledge that I can print off a copy of Bucks County Anxiety Center’s Privacy Practices from the website. All of the providers at Bucks County Anxiety Center follow the same privacy/HIPAA practices.