Client Information Forms
HIPAA Forms
1. This Therapist Client Agreement is provided to allow you to add a copy to your own files and does not require a signature.
Download: Therapist Client Agreement
2. This HIPAA form notifies you of our privacy policy and does not need a signature.
Download: Notice of Privacy Practices
3. This is a consent form to participate in Telehealth Therapy Services.
Download: Consent To Participate in Telehealth Therapy Services
4. This is a consent and information form for Psychotherapy for Children and Their Families Proceeding Through Separation and/or a Divorce Process
5. This is a consent Regarding Co-parenting of Separated And/or Divorced Couples
Download: Informed Consent Regarding Co-parenting of Separated And/or Divorced Couples
6. By signing this form you are agreeing to our HIPAA policies as well as authorizing us to bill your insurance
Download: HIPAA Client Acknowledgement
Referral & Release Form
7. A copy of our referral form is available here.
Download: Referral Form
8. Our Information Release Form is available here.
Download: Information Release Form