New Client Paperwork

Practice documents  

Privacy Practices for Protection of Health Information (HIPAA)

Limits to Confidentiality

Rights and Responsibilities

Electronic Communication Policy

 

Forms to complete

Personal Information Form

Practice Information and Consent to Treat

Financial Responsibility and Signature Form

In-person Instructions

Please bring all completed forms with you to your first session. 

Please bring your insurance card, if you are utilizing insurance. 

Telehealth Instructions

Please email all completed documents AND a copy of both the front and back of your insurance card, if you are utilizing insurance.  You will email all of this via an encrypted email your therapist will send to you for this purpose.  

You will also need to complete a Telehealth Consent Form, which is completed and submitted online. 

Telehealth Consent Form

Release of information 

If you would like us to coordinate care with another provider, for example, your psychiatrist or primary care physician, please complete this form to authorize release of information. 

This document is not required for your first session.

Release of Information Form

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