Several forms need to be completed before your first appointment. All forms are available at the office, however filling them out in advance saves time. Please print and complete the following documents. Forms required are noted by an asterisk. Please feel free to contact me if you have questions regarding any of the forms.
Notice of Privacy Practices: This is your copy of Notice of Privacy Practices
*Notice of Privacy Practices Acknowledgment
*Insurance Checklist: If you plan on using your insurance benefit, please use this form as a guide to contact your insurance company to confirm mental health benefits.
*Assignment of Benefits: Required if using insurance benefits
Credit card Agreement: If you wish to use a credit card for payment of services, please complete this form
This PDF contains all of the forms listed below in a single document.
Adobe Acrobat document [101.1 KB]
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