After you have scheduled your very first visit with me, I will send you a secure link via email to complete documents online via Simple Practice. Completing these ahead of time (preferably at least a day or two prior to your intake session) will allow us to begin on time and maximize the potential for your session.
These documents linked below are for backup purposes only should the Simple Practice site not be working correctly. Please make every effort to complete online when you receive the link.
In the event these forms must be used, please print, complete, and scan these forms back to me prior to your intake or upload to Simple Practice).
- Consent for Treatment (Agreement for Services):
- Notice of HIPAA Privacy Practices (How your personal information is used):
- Adult Client Information Form (18 years of age and up):
- Youth Client Information Form (0-17 years of age, guardian to complete):
- Insurance Agreement Form (For clients using their insurance benefits):
- Insurance Opt-Out Form (For clients who decide to opt-out of using their insurance benefits for which I am In-Network):
- Distance Counseling Form (For clients who have been screened for online distance counseling only)
To view, download, and print these documents, you must have Adobe Reader installed on your computer. Please click the link below to obtain a copy of Adobe Reader.
