After you schedule an appointment with me, either video or in person, please download the first three forms on this page. They must be read through, filled out, signed and dated. For those coming to an in person appointment, please bring them with you when you come in.
For those scheduling a video session, since the forms may be filled out online, please do so and send them back to me at least two days before your session is scheduled at the following email address: firstname.lastname@example.org. In addition, I will need you to have your credit card information handy so that I can run it through before our session begins.
If I do not have these forms at the beginning of your scheduled session or, if you do not have a valid credit card, I will not be able to conduct the video therapy session.
We could take some of the time in your session, but I would much rather devote all the time we have to hear your concerns rather than fill out paperwork.
The Client Information Form is simply a form where I can get to know you better as well as understand your goals for therapy a bit more.
The Client Informed Consent form is a detailed description of how I work and what you can expect in therapy with me. It’s important for you to fully understand the details outlined and I suggest you read through it carefully before your session
I will need you to sign one copy of the form and date it for my files. Should you have additional questions about any of it, I will be happy to answer them for you at the beginning of your session with me.
The HIPAA Form is required by law and specifies the terms of the confidentiality of your personal health information kept in your file at my office. You won’t need to sign and date it. It is simply something you should read through so that you are aware of what the confidentiality limits are for your information. Again, we can talk more about any questions you have at the beginning of our session together.
Thank you in advance for your cooperation