Please download, read, fill out and sign the forms below before coming in for your first appointment. If we are going to work by phone, please fill out the paperwork and email me as an attachment, or send by mail.
The Intake Form provides me with some background information about you that will help us in our work together.
The Informed Consent form is a disclosure statement that simply states the way I work, our agreements regarding fees, limits to confidentiality, risks and some of the laws governing our work together.
And finally, the Notification of Patient Rightsis also known as the federal “medical records privacy law”, or HIPAA (Health Insurance Portability and Accountability Act). This law requires that I give you a copy of this document and that I secure your signature indicating you have received a copy of it. Laws such as these are important, but also complex and in this Notification of Patient Rights document I have tried to inform you about your rights in plain, simple language. Please read the contract and do not hesitate to ask me about any questions you might have about its content.
