top of page
Check here to stay up to date on any major changes.
Check here to stay up to date on any major changes.
New Client Information
(*New Client)
Insurance
Registration
(*New Client)
Agreement to Treat
(*New Client)
Privacy Policy
(*New Client)
Forms
Forms will now will be conveniently filled out on my on-line portal with E-signature
and HIPPA storage. A photo of your insurance card, front & back, will be easy to upload.
Deductibles often have to be met before benefits kick in, especially at the beginning of each year. It's important for you to check on what your plan requires. This is your responsibility and helps cut down on unpleasant surprises of a high balance.
Also, check to see if you need a referral and obtain one if needed before your first session.
Below are examples of new client forms.
Consent for Release of Information
(*New Client)
Consent to consult with your PCP is required. Others may be included, as needed, such as school conatcts, specialists, or family members.
Parental Consent to Treat a Minor Child
(**Under 18 Only)
Mental Health
Bill of Rights
(your right to know what your rights are)
bottom of page