Client Forms for Psychotherapy
Client Forms
Forms can be daunting, but they are necessary and helpful as we work together. Please read, fill out, and sign these documents before your first appointment. The disclosure statement is something I provide you by law and simply states the way I work and some of the laws governing our work. The information sheet will provide me some background information about you which will help us in our work and will help me begin to get to know you. The Privacy Practices document explains your rights under the HIPPA laws.
- Informed Consent for Psychotherapy
- Informed Consent for Telepsychology
- Emergency Contact for Telepsychology
- Notice of Privacy Practices and Client Acknowledgment
- Client History Form
- Non-Medicare Provider Acknowledgment
- Client Payment Authorization
- Authorization to Release Confidential Health Information
- Good Faith Estimate