{"id":195,"date":"2018-12-07T20:19:19","date_gmt":"2018-12-07T20:19:19","guid":{"rendered":"https:\/\/www.nepvneuro.com\/?page_id=195"},"modified":"2026-05-21T17:48:34","modified_gmt":"2026-05-21T17:48:34","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.nepvneuro.com\/?page_id=195","title":{"rendered":"Forms"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”4.16″ background_image=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2018\/12\/what-is-Neuropsychology.jpg” parallax=”on” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_divider show_divider=”off” _builder_version=”4.16″ height=”100px” global_colors_info=”{}”][\/et_pb_divider][et_pb_text _builder_version=”4.16″ text_font=”|700|||||||” text_font_size=”50px” background_layout=”dark” text_text_shadow_style=”preset1″ global_colors_info=”{}”]Forms[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ parallax=”on” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.16″ text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n

Welcome Letter<\/strong><\/h3>\n

Please download our welcome letter for additional information on your first appointment with us.<\/p>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2023\/07\/Welcome-Letter.pdf” url_new_window=”on” button_text=”Welcome Letter” _builder_version=”4.16″ header_font=”||||||||” background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][et_pb_text _builder_version=”4.16″ text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n

Appointment Security Deposit<\/strong><\/h3>\n

We require a $100 dollar appointment security deposit that is to be made when you schedule your initial intake. Please find the info sheet below for further details regarding this policy. Please contact our office if you have any questions or concerns.<\/p>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2024\/06\/Appointment-Security-Deposit.pdf” url_new_window=”on” button_text=”Appointment Security Deposit” _builder_version=”4.16″ header_font=”||||||||” background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][et_pb_text _builder_version=”4.25.1″ text_font_size=”24px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n

Medical Release<\/strong><\/h3>\n

[\/et_pb_text][et_pb_cta button_url=”https:\/\/www.nepvneuro.com\/?page_id=847″ url_new_window=”on” button_text=”Medical Release” _builder_version=”4.25.1″ background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2024\/06\/Medical-Release-NVN-06-2024-digital.pdf” url_new_window=”on” button_text=”Medical Release (downloadable)” _builder_version=”4.27.0″ background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][et_pb_text _builder_version=”4.16″ text_font_size=”18px” text_line_height=”1.8em” custom_padding=”||0px|||” global_colors_info=”{}”]<\/p>\n

Credit Card Authorization<\/strong><\/h3>\n

We require a credit card on file for all appointments. Your card will only be charged for outstanding deductibles and\/or not showing for your appointment without 48 hours notification.<\/p>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2024\/06\/CreditDebit-Form-06-2024-digital.pdf” url_new_window=”on” button_text=”Credit Card Authorization Form” _builder_version=”4.16″ background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”27px|0px|0|0px|false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.16″ text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n

Credit Card Authorization FAQ<\/strong><\/h3>\n

Please review from frequently asked questions and additional information regarding our credit-card on file policy.<\/p>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2026\/03\/Card-on-File-FAQ.pdf” url_new_window=”on” button_text=”Credit Card FAQ” _builder_version=”4.27.6″ header_font=”||||||||” background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”22px|0px|22.9545px|0px|false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Please find the Summary of Privacy Practices available for you to download.<\/h4>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2018\/12\/Privacy-Practice-Notice.pdf” url_new_window=”on” button_text=”Summary of Privacy Practices” _builder_version=”4.16″ background_color=”#0d7edb” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_cta][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”22px|0px|22.9545px|0px|false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Please find an info sheet on what to expect at your testing appointment.<\/h4>\n

[\/et_pb_text][et_pb_cta button_url=”http:\/\/www.nepvneuro.com\/wp-content\/uploads\/2026\/05\/What-to-expect-when-youre-testing.pdf” url_new_window=”on” button_text=”What to Expect on Testing Day” _builder_version=”4.27.6″ background_color=”#0d7edb” hover_enabled=”0″ border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off” sticky_enabled=”0″][\/et_pb_cta][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

FormsWelcome Letter Please download our welcome letter for additional information on your first appointment with us.Appointment Security Deposit We require a $100 dollar appointment security deposit that is to be made when you schedule your initial intake. Please find the info sheet below for further details regarding this policy. Please contact our office if you […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-195","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/pages\/195","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=195"}],"version-history":[{"count":10,"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/pages\/195\/revisions"}],"predecessor-version":[{"id":1040,"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=\/wp\/v2\/pages\/195\/revisions\/1040"}],"wp:attachment":[{"href":"https:\/\/www.nepvneuro.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}