Intake and Release Form

Once completed we can get your labwork and cognitive assessments scheduled. 

HIPAA Policy Form

HIPAA and protected health information policy. 

Therapy Studio Release Form

If you will be participating in the use of our brain therapy gym (local to Frederick, MD only), please complete this form. 

Medication and Supplements Form

Please note any medications and supplements you are taking including time of day and dosage. 

Release of Information Form

This allows us to release your protected health information to the entities of your choice.