Your First Visit

Your First Visit Forms

For your convenience, please complete the forms provided here.

Client Information: Save time. Please complete, print, and bring a copy of this form with you to your first visit.

Information and Agreement: Please print and sign two copies of this form and bring them with you to your first visit.

HIPAA Form: The law requires that you are provided and acknowledge receipt of the Health Insurance Portability and Accountability Act.

Acknowledgement of Receipt: Please print and sign this Acknowledgement and bring it with you to your first visit.

Electronic Communication Disclaimer
Please sign this Disclaimer to indicate your agreement to engage in Telehealth as an alternative to in-person therapy when meeting face to face is not feasible.

Forms best viewed with Adobe Acrobat Reader:

Windows PC
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iPhone and iPad
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Android
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