Child & Teen Therapy - Forms

Welcome Packet

Get oriented by reading the below before your first appointment.  

1.  Office Policies

Learn about confidentiality, benefits and risks, the process and payment.

2.  Notice of Privacy Practices

Understand your rights and my commitment to keeping your private healthcare information secure and confidential.  

3.  Social Media Policy

Know about how I conduct myself on the Internet as a therapist.

Print the following two documents.  Please bring the completed versions to your first appointment. To protect your and your child's privacy, do not email me the completed forms.

4.  Client Information

Share some background to help me understand your child better. 

5.  Consent

Acknowledge you have read the forms and sign the consent.

During Therapy

1.  Authorization for Exchange of Information

Give me permission to consult or exchange information.