Before we meet If you have the opportunity to do so before we talk by phone, please review the my Office & Privacy Policies Form (available for download at the bottom of this page).This form explains my office procedures, policies and agreement for counseling services. This includes important information about your confidentiality. If you have questions after reading this form, please bring them up when we speak.
Please print out the Registration Packet at the bottom of the page, fill it out and bring the forms, as well as your insurance card and payment, to your first session.
The Registration Packet includes:
Client Registration Information: This form asks you for basic demographic information, emergency contact information, and insurance information
Primary Care Physician Notification Form: This form is a letter that is sent to your Primary Care doctor to inform them that you have begun counseling. (It is not an ongoing release of information.)
Office & Privacy Policies (see top of page)
HIPAA Notice of Privacy Policies: I am required by law to provide you with a copy of the HIPAA Notice of Privacy Policies so you can understand your rights and protections related to the use and disclosure of your health care information.
Credit Card Authorization Form/Electronic Payment Communication Disclosure Form: This form is for you to put a credit card on file to be billed if you ever have a balance that is more than 60 days overdue.