Hope Psychology Group Inc.
P.O. Box 53633, Irvine, CA, 92619
Tel: (949) 677-5589
Fax: (949) 725-0914
Dear Client:
Please go to our website (https://www.hopepsychgroup.com) and fill out Adult or Children office paperwork and/or Adult or children client evaluation (testing) and if you are using EAP, then fill out the EAP Authorization Form.
Please remember:
1. To initial and sign all the forms.
2. If you have insurance, you are only responsible for the copay and/or deductible.
3. You will need to pay the copay/deductible on the day before or same day as your appointment, by using Zell to my phone number 949-677-5589
4. Forms must be back to me before your appointment. Please let me know if you have completed the paperwork and emailed them to me.
Thank you
Dr. Sahar Teimoori
P:949-677-5589
F: 949 725-0914
Email: ssteimoor@gmail.com
Mailing address: P.O. Box 53633, Irvine, CA 92619
Child Intake Form
Verified by
Psychology Today
License:
California / 17444
School:
Eastern Washington University & University of WA
Year Graduated:
1987
All Rights Reserved | Hope Psychology Group, Inc.