New Client Forms

Please read and sign the following forms previous to our appointment. If you are seeing me as couple or family each one of you needs to fill out the forms.

1. Acknowledgement of receipt of privacy practices https://hipaa.jotform.com/220636151465048

2. Good faith estimate https://hipaa.jotform.com/220636992605057

3. Informed consent https://hipaa.jotform.com/220640479791058

4. Teletherapy addendum https://hipaa.jotform.com/220640707660047

5. Risk to electronic transmission of information https://hipaa.jotform.com/220641481774053

6. Payment authorization form https://hipaa.jotform.com/220642471460045

7. Intake https://hipaa.jotform.com/220640882779062

(This form allows me to collect important information before our appointment, it will take you about 20 to 30 minutes to fill out. Completing this form allows us to be more efficient with time in our first session)

If our appointment is online, you have received an email with a link to connect to google meet. I recommend you read the following form https://hipaa.jotform.com/220642028069048 which you also received included in the invitation to our google meet meeting

Additional form for in person appointments:

• Covid 19 form https://hipaa.jotform.com/220641800495048

• If you appointment is in person please review directions on how to arrive here

Looking forward to meeting you.