Forms

Dear Client,

Below are the forms I am required to provide for you. You will need certain forms at certain times in our work together. Please don't hesitate to contact me with any questions.

Client Information

Client Information is requested for each client, whether coming individually or as a couple or family. It tells me a little about your background and gives you an opportunity to tell me anything you want me to know ahead of our session. Please complete and bring to your appointment or email to me.

Disclosure provides you with information about me, my policies and your rights as a client.

HIPAA notifies you of the privacy of your medical records.

Teletherapy gives consent to conduct remote sessions by phone or video.

Unsecured Communication provides information around electronic communication.

The remaining forms will apply if there is a specific need in our work together.

Collateral is required for you to give permission for another person to attend one or more of your sessions.

Release of Information is required if you want me to share information about our work together with another person.

Covid is a waiver in case there is increased risk of Covid infection.

Unsecured Communication

Collateral

Release of Information

Covid