Client Forms
Once Your Appointment is Scheduled
Below is a list of Client Forms. Once we have scheduled your appointment, I will let you know which of the forms you will need to complete and bring to your session. Please carefully read and complete the specified forms prior to our initial session. We will review these forms together during your initial appointment.
If you plan to use insurance or EAP services, you will need to bring your card, copayment (if applicable) and information to the session (if applicable). Please arrive for your scheduled appointment on time. Clients who arrive late will be responsible for the full cost of their appointment. If you are unable to keep an appointment, please call me at least 24 hours in advance so I may use the time for other clients.
I look forward to seeing you!
Click Below to download Client Forms:
- New Client History and Assessment (adult)
- New Client History and Assessment (child and adolescent)
- Client Information and Consent
- Covid Release for Treatment
- Financial Information and Agreement
- Credit Card Authorization
- Privacy Practices Agreement
- Private Pay Agreement
- Request/Authorization to Release/Obtain Confidential Records and Information
- Standards of Communication
- Telehealth Informed Consent