Pisgah Institute

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The Pisgah Institute

Welcome to the Pisgah Institute and the Center for the Advancement of Human Potential. Here you will find the downloadable versions of the paperwork you will need to complete and bring with you on the day of your visit. Please click the link to download the forms, print them out, and complete them prior to your visit.

All forms are in PDF format and require Adobe Reader. This is a free download and is compatible with any computer system.

New Patient Paperwork:

New Patient Paperwork

Additional Forms:

Authorization to Charge Credit Card

Infant-Young Child Parent Questionnaire

Initial Adult Assessment Form

Medical Record Release

Responsible Party Payment Form

Information and Policies:

Medication Prescribing Policies and Procedures