Please print the following forms, fill them out and bring them to your initial appointment. In this way, we can spend more time in session and less time on paperwork. If you have any questions about any of these forms feel free to skip that section and bring it with you to your first session. We ask that each new client also keep a credit card on file so that we can expedite billing services. Thanks!
The following are mandatory forms for all new clients. Please click on the image above each description to download and print each form.
RECEIPT OF PRIV. PRACTICES
CREDIT CARD AUTHORIZATION
Below is an optional form. It is only for the purpose of the use with Skype and other telecommunication formats, if you choose.
TELECOMMUNICATION RELEASE OF INFORMATION
Please Note: You may need to print the file called "Release of Information" more than once. This document allows us to communicate with others outside of our practice. For example, if you are using insurance you will have to fill this out and name your insurance provider. If you are seeing another healthcare provider, such as a pediatrician, psychiatrist, other therapist, etc., we may need to communicate about your care, at your discression. We can only openly communicate with others outside of our practice with your written consent. If you have any questions regarding which boxes to check or lines to sign feel free to ask your clinician at your first appointment.