Patient Forms

sandPlease plan on arriving 15 minutes early for your first session.  Please print out the forms and complete all of the forms before your first session. There are a few other forms you may need to sign when you come in that are not on our website including :

1. Consent for Treatment form (clarifying expectations of our counseling relationship)
2. HIPPA policies for our office.
3. Release of Information (if needed)
4. Consent for treatment of a minor (if needed)

You will receive a copy of our HIPAA (Health Insurance Portability and Accountability Act) policies as well as our office’s policies. HIPAA is a federal law protecting your health information (Protected Health Information). The Notice of Privacy Practices describes how we protect your PHI in accordance with applicable laws and the NASW Code of Ethics.

HIPAA Notice of Privacy Practices

Intake Form

Statement of Understanding

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