Client Forms
If you’re a new client, please complete the following forms and bring them to your first session:
- Child Client Information Form or Adult Client Information Form
- Informed Consent Form
- HIPPA Consent Form
- Child and Adolescent Client Intake Form or Adult Client Intake Form
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, teacher, etc.), complete this form to authorize release of information:
HIPPA Notification
Information
Joshua Shifrin, PhD, ABSNP, NCSP
Office Address: 2 West Northfield Rd. Suite 201A Livingston, NJ 07039
Mailing Address: 52 Holiday Dr. West Caldwell, NJ 07006
West Northfield, NJ Office 860-966-0309 drshifrin@yahoo.com
Thank you for visiting the online office of Dr. Joshua Shifrin. Dr. Shifrin is a licensed psychologist in New Jersey, a Diplomate of the American Board of School Neuropsychology, as well as a Nationally Certified School Psychologist, who specializes in pediatric/school neuropsychological evaluations Ages 5-25. Please feel free to view this website for more information about the services Dr. Shifrin can provide for you, and your child.