Client Registration
Required Paperwork
Telehealth Informed Consent
Additional paperwork required when initiating any services via Telehealth. Download here...
Consent to Treat During COVID
Additional paperwork required when using in-person services during COVID-19 health risk. Download here...
Release of Information
Option to complete when coordinating care with another provider or designee. Download here...
Client Update Form
Required with changes to insurance, financial, or contact information. Download here...
Credit Card Encryption Form
Suggested when submitting bill payment by credit card. Form will be destroyed after information is encrypted. Download here...
How to Complete and Submit Paperwork
Office Appointment Download, print, and complete paperwork based on the service you are initiating and bring it with
you to your first appointment.
Telehealth Appointment Download, print, and complete paperwork based on the service you are initiating. Scan or take a
photo of your paperwork and send it via email*. You may also fax or send via USPS.
*NOTE: Although our email system is protected by encryption, there are possible risks associated with sending your personal health information (PHI) through any email system that is not encrypted. Please consider using password protection or another encryption application to send PHI via email.
We offer psychotherapy via videoconferencing technology. Please call to discuss if this option
is right for you.
Our clinicians practice in accordance with the professional and ethical guidelines of their respective boards and professional organizations.