Forms .

Practice Policy

This Practice Policies document should be dowloaded, signed, dated and returned in order to set an appointment.  

 

If you have any questions, please do not hesitate to contact me. 

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. 

COVID 19 Informed Consent Form

The COVID Informed Consent Form is required for those wishing to meet in my office instead of using Telehealth services. Please note, that I am following CDC and WA state guidelines and may need to terminate office availability if guidelines change.

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.