Below are several forms that you will either need to read and sign, or fill out and sign.

To help things go as smoothly and easily as possible when you come for your first session, we strongly recommend that you print out and complete the Intake Form and bring this with you to your first session. If you do not do this prior to coming for your session, we suggest you arrive at least 15 minutes early so you can complete this form before the session is scheduled to begin. This will help ensure that you have the maximum amount of time to spend talking with your therapist rather than doing paperwork. 

Please note that each adult who is participating in the therapy process needs to complete the following forms: 

Intake Form: IntakeForm-Therapy.pdf


Consent to Treat: ConsentForm.pdf

Telehealth Consent Form: Telehealth Consent Form

Your privacy and rights are very important, please print and sign the signature pages for the :

HIPPA Notice: HIPPANotice.pdf 

If you are planning to pay your copay/fee with a credit card please fill out this form and bring with you. 

Credit Card Authorization form: Credit Card Authorization Form

If being seen in the office please fill out this COVID Consent Form in addition to the Consent to Treat: COVID Consent

If there is a need for me to share information with another provider (doctor, school, therapist, etc.) this form will also need to be completed and signed

Release of Information Form:ROI.pdf

 

 

REIKI FORMS

ReikiIntake.pdf

 


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