Forms

Please call our office to schedule. 

Forms downloadable PDF files and are grouped by age. Please download one of each form, print, and complete.  Bring the completed forms to your first appointment.  


Questions?  Call our office or email Dr. Cooper.

Children (ages 5-11)

As a convenience to you, we bill most insurance providers.  Dr. Cooper is a preferred provider with several companies, including Blue Cross Blue Shield, and Lifewise.   Dr. Cooper is a Medicare provider. 


We recommend you contact your insurance company to verify your benefits.  


​Payment is expected at the time of service.  

Adults and couples (ages 18+)

Psychotherapy and assessment for

children, Teens, and adults


NONDISCRIMINATION POLICY:


It is Dr. Cooper's policy to provide treatment at all individuals seeking services, regardless of race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, disability, level of education, political affiliation, source of income, or place of residence or business. A sliding fee schedule (based on income and family size) is available at our office.


Teens (ages 12-17)

Insurance Information

Jennifer K. Cooper, Psy.D.​​

​Clinical Psychologist