DR. NETTA SHAKED - SOUTH BEACH PSYCHOLOGIST

Forms
DR. NETTA SHAKED
SOUTH BEACH PSYCHOLOGIST


So as to save to save time during your first appointment, please download and complete the appropriate form below. 

You may complete this form on your computer and sign it electronically, or just print and complete the old fashioned way. 

Please email/fax this form to Dr. Shaked at least one day before your appointment.

The forms are password protected. 

Please complete if you're an adult therapy patient, and/or a member of couples therapy.

Please complete if you're an adult undergoing testing or evaluation, but not therapy. 

For anyone under the age of 18, and must be filled out by a parent

For anyone under the age of 18, and must be filled out by a parent

To release any information to any third parties (including schools, other professionals, or family members), I must have this form completed and signed. 

SOUTH BEACH PSYCHOLOGIST ®  
Free parking nearby. In South Beach, just minutes from downtown Miami, Brickell, Biscayne, Miami Beach, North Beach, Surfside, Bay Harbor, Bal Harbour, and other South Florida neighborhoods. 

Copyright © Dr. Netta Shaked, PA. All Rights Reserved.

South Beach Psychology Office: 1000 5th Street, Suite 215, Miami Beach, FL 33139