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FORMS

 

Download and fill out the following forms prior to our first meeting.  If you have any questions regarding any of these forms, please feel free to discuss with me.

This is the informed consent form.  Please read this very carefully and make sure you understand all of the contents of this form.

This is the informed consent form for Teletherapy.  Please read this very carefully and make sure you understand all of the contents of this form.

This is a signature page for the privacy policy.

Please fill out this form so that I have your basic contact information.

 

The second form is a release of information and can be used when you would like me to speak with other practitioners about your care.

This form outlines your rights to privacy and how your protected health information will be used when I bill your insurance.

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