NEW CLIENTS: I will have all documents below available in paper copy for your first session. I provide them here for your convenience if you wish to download, print and complete them before we meet. Whether brought to the session or completed during our first session, we will devote appropriate time for review of my policies and your client rights during our initial appointment. You may copy or simply read the HIPAA form; I need only a signed copy of the signage page (last page of the document) for your file.
Group I forms (required for all)
- Client Information Form
- General Disclosure Form
- Limits of Confidentiality/Therapy Cancellation Policy
- Notice of Privacy Practices (HIPAA) form for adults with signage page
- Notice of Limits of Confidentiality for adolescents form with signage page
OTHER FORMS WHICH MAY BE REQUESTED OF YOU LATER:
- Counseling Intake Form
- Authorization to Disclose Information Form (often called "release of information" or ROI)
- Eating Disorder Questionnaire (EDE-Q6)
Note: To download Adobe Acrobat Reader for free, click here.