The following forms are required to be submitted to your therapist prior to your first appointment. I know it looks like a lot; I have tried to make the information easy to read and understand. Many of these forms are required by state and federal law, as well as insurers. I thank you for taking the time to fully read, understand, and complete these documents.

These forms are typically shared and electronically completed via the client portal, which can be set up when you call to schedule your first appointment. If you experience difficulty with using the portal, or simply would like to access blank copies of these forms, feel free to download the files. Please note that not all documents have a signature line included due to the use of e-signatures via the portal. Please contact me if you have any questions or need modifications made to the formatting.

General Informed Consent - Outlines important policies and business practices to ensure clients have a clear understanding of what to expect while receiving services.

Telehealth Informed Consent - Outlines specific policies and considerations for clients utilizing telehealth services.

Informed Consent for Minors - Outlines specific policies and legal information related to working with persons under 18 years of age. This form contains information for both minors and parents so that treatment and privacy expectations are clearly understood upfront.

HIPAA Privacy Notice - Outlines required information about the Health Insurance Portability and Accountability Act (HIPAA).

Financial Responsibility Agreement - Outlines payment policies

Credit Card Authorization Form - For use when someone other than the client is paying for services or otherwise assuming financial responsibility. This form is also required when working with minor aged clients. Must be accompanied with an ROI form.

Electronic Communications Waiver - Outlines expectations for out-of-session communication and enables clients to permit the use of email and text messaging with their therapist.

Release of Information (ROI) - Permits your therapist to communicate as needed or requested with a person/entity who may be involved in your care. Clients are required to complete ROI’s for their insurance company and are encouraged to complete ROI’s for their medical provider(s) and emergency contacts. Minors are required to sign an ROI for at least one parent/guardian.

• Many people express confusion about how to complete ROIs, so you may wish to view examples of completed ones for insurers, doctors, emergency contacts. Please note that these are only examples of how you could complete the form, and do not necessarily represent responses that will be reflective of your individual ROI considerations.

Intake Questionnaire - Provides your therapist with important information about your reasons for seeking services, as well as basic information on mental health history and physical health. This form greatly helps your therapist in determining the best treatment approach for your needs and in creating your treatment plan. Please be as detailed as you feel would be helpful.