Dr. David Wade

Licensed Psychologist

Private Practitioner

Forms

Please download and complete all forms and bring them to our first appointment

For clients 18 and younger

or still in high school

  1. Client Information Form
  2. Child History Form (18 and younger)
  3. HIPAA Statement
  4. Disclosure for Treatment
  5. Informed-Consent-Checklist-for-Telepsychology-Services
  6. Authorization for Release/Exchange of Information

For clients 19 and older

  1. Client Information Form
  2. Adult Personal History Form (19 and older)
  3. HIPAA Statement
  4. Disclosure for Treatment
  5. Informed-Consent-Checklist-for-Telepsychology-Services
  6. Authorization for Release/Exchange of Information

David C. Wade

Psy.D., PC

1100 E Marina Way, Suite 221
Hood River, OR 97031
Licensed Psychologist: OR 1081

Phone: 541-386-2998
FAX: 541-387-2962

Office Hours

Monday – Thursday
8:00-6:00
some Friday mornings

Copyright 2019 Dr. David C. Wade