Thank you
You Patient Registration Form & Health Questionnaire were submitted directly to Dr. Michael Heitt.Now, please download hard copies of the Summary of Agreement, Maryland Notice Form and Psychologist-Patient Agreement. You will want to read and understand these forms and bring a signed copy of the Summary of Agreement form with you to your initial appointment.
You can now return to the New Clients page.
Please note: Electronically submitting these forms does not constitute a therapeutic relationship.