Please fill out forms 1-7 prior to your first therapy appointment. This will allow more time during our first session. I only need the last page (signature page) for Form 2. Form 8 can be filled out ahead of time or during our first session. Please type or write answers on the forms and scan them back to me. Most signatures will need to be hand written if you are unable to sign electronically. Please call with any questions. Thank you.
1. CLIENT REGISTRATION FORM (docx)
Download2. PRIVACY POLICY HIPAA (pdf)
Download3. NO SHOW-CANCEL FORM-and-CO-PAYMENT OPTION (pdf)
Download4. AUTH for ELECTRONIC COMMUNICATION via VIDEO CONF, EMAIL or TEXT (pdf)
Download5. Telemental Health Informed Consent NASW (pdf)
Download6. CREDIT CARD AUTHORIZATION FORM (pdf)
Download7. FINANCIAL FEES and CONSENT for MENTAL-BEHAVIOR HEALTH THERAPY (pdf)
Download8. 1ST VISIT CLIENT INTAKE FORM (docx)
DownloadThese documents are as-needed.
9. ROI (docx)
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