Forms

Before we meet:

Please read, download, and print the forms below and bring them to your first appointment.  If you have questions after reading this form, please bring them up before you sign.

Agreement for psychological services

Supplemental Billing Agreement Regarding Insurance Reimbursement

HIPAA notice of privacy practices

This form explains my office procedures and agreement for psychotherapy and/or testing services. This includes important information about confidentiality, fees, cancellations, and other matters.

I am required by Federal law to provide you with a copy of the HIPAA Notice of Privacy Practices so you can understand your rights and protections related to the use and disclosure of your identifiable health care information.