Client Forms

Therapy Clients can print out, read, sign and bring to first session the following forms or complete in person:

 

Informed Consent for Psychotherapy Services

Notice of Privacy Practices (Client hand-out) 

Telemedicine Informed Consent Form

EMDR informed consent form for adults

treatment fee agreement

If you would like to give permission for me to communicate with a specific person, provider, etc. on your behalf for the purpose of coordinating care or treatment, please print out, sign and bring to session (or email, fax, mail) the following Authorization to Exchange Confidential Information Form:

Authorization To Exchange Confidential Information

New IST or Coaching Clients can complete and bring the following questionnaire to their first visit or complete it during session:

Life Coaching Questionnaire

 

Leave a Comment

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s