Intake Forms
At Carolina Performance in Raleigh, our psychologists, psychiatrists, and therapists are in solo private practice and require their own individualized intake forms that are necessary for your first appointment.
Intake Forms
Please download and print the intake form that corresponds to your provider. Please bring completed contact information and signed consent forms to your first appointment. The remaining pages are for you to keep for your records. Feel free to contact us if you have any questions about filling out the forms.
Dr. Eric Morse
Click here to download Intake Form (.pdf)
Dr. Joshua Dittmer
Click here to download Intake Form (.pdf)
Dr. Jun He
Click here to download Intake Form (.pdf)
Darcee L. Ruble, LPC, LCAS
Click here to download Intake Form - Adult (.pdf)
Click here to download Intake Form - Child (.pdf)
Dr. Hima Palakurthi
Click here to download Intake Form (.pdf)
Dr. William Matthews
Click here to download Intake Form (.pdf)
Dr. Heidi Green
Click here to download Intake Form (.pdf)
Dr. Mitushi Mishra
Click here to download intake form (.pdf)
Dr. Michelle Goldberg
Click here to download Intake Form (.pdf)
Dr. Jozef Zelenak
Click here to download Intake Form (.pdf)
Cari DeCandia, EdD, CMPC
Click here to download Intake Form (.pdf)
Dr. Jamila Battle
Intake forms and appointments can be requested through the Klara patient portal online at www.DrJamilaBattle.com