Client Information Forms

Print and fill out the appropriate form.

HIPAA Forms

1. This Therapist Client Agreement is provided to allow you to add a copy to your own files and does not require a signature.

2. This HIPAA form notifies you of our privacy policy and does not need a signature.

3. This is a consent form to participate in Telemental Health Therapy Services.

4. This is a consent and information form for Psychotherapy for Children and Their Families Proceeding Through Separation and/or a Divorce Process

5. This is a consent Regarding Co-parenting of Separated And/or Divorced Couples

6. By signing this form you are agreeing to our HIPAA policies as well as authorizing us to bill your insurance

7. A copy of our referral form is available here.

8. Our Information Release Form is available here.