Forms

Before you arrive for your first appointment, please download and review the forms below.  These forms spell out some of the expectations of the professional relationship, as well as the legal limits to confidentiality. 

Consent Form

Here you will find important information regarding my professional services and detailed information about appointments, confidentiality, fees & billing, insurance and record keeping (to list a few). Please take some time to read this document in preparation for your first session. Your understanding of this basic agreement and my effort to provide you with up to date consumer information will serve as a foundation for a good working alliance and will enhance the likelihood of positive outcomes from our work together.  Make a note of any questions you have and bring them with you to the appointment.  I will be happy to answer them. 

Consent for Treatment- for our first appointment

Privacy Rights

It is important to know that you have rights and responsibilities regarding disclosure of your Personal Health Information (PHI) by any healthcare provider or agency.  Carefully read the following privacy document and, if possible, print and bring your copy to the first appointment.  During our meeting, I will review the Notice of Privacy Practices with you and answer your questions. At that time, I will ask you to sign and date the form and will provide a copy for you to keep.  For additional information regarding your confideniality, please visit the American Psychological Association Help Center. 

Notice of Privacy Practices- for our first appointment