top of page
Forms .
Practice Policies
confidentiality, cost, expectations and theory of practice.
Telehealth Consent Form
The Telehealth Consent form is for your health safety (and mine) during the Covid-19 pandemic if you choose to use Telehealth to meet remotely.
This form acknowledges the benefits and possible challenges of Telehealth therapy.
Your physical and mental well-being are are paramount to your care and i look forward to seeing you in person as soon as possible.
Release of Information (ROI)
The Release of Information (ROI) form is required by law for me to speak to health practitioners and other professionals who may be involved in your care.
Safety Plan
Please down load this form and fill out if yur struggle with suicidal thoughts and need to create a plan that identifies triggers, who to call, action to take, etc.
HIPPA Notice of Privacy Practices for Protected Health Information
This notice describes how medical information about you is stored, disclosed, used, your rights and access to your information.
Social Media and Electronic Communication Policy
This document outlines my office policies related to use of social media and electronic communications with the goal of safeguarding your privacy.
Professional Will
This document contains instructional information in the case of my inability to perform therapy due to death or becoming incapacitated.
bottom of page