Client Forms

The Intake Packet, as well as the Consent for Telemental Health via Phone or Video, must be completed and uploaded to Dr. Bornstein at least 24 hours before the first appointment.

Intake Packet

Consent for Telemental Health via Phone or Video

Medicare Contract

Release of Information

Collateral Form

Couples Questionnaire (complete one copy per each client)

Select and download the appropriate form(s) to your local computer, open in Acrobat Reader (not in the browser), and then complete and save each. To upload form(s) to Dr. Bornstein's secure platform, select this SUBMIT FORMS HERE link. Use these steps to upload each file individually. Please note that typing your name in a signature block constitutes your electronic signature.

Open Adobe Reader download page in a separate browser tab

You may contact Dr. Bornstein at 404-236-9210 with any questions or concerns.