Patient Forms
- Required Forms – This packet includes every form that is legally required to start therapy for a fully licensed therapist.
- a. Telehealth Informed Consent/Agreement for Services
- b. Notice of Policies and Practices Regarding Privacy of Health Information-HIPAA,
- c. Clinical Professional Agreement for Services
- Required Forms Provisionally Licensed Therapist – This packet includes every form that is legally required to start therapy for a provisionally licensed therapist.
- a. Telehealth Informed Consent/Agreement for Services,
- b. Notice of Policies and Practices Regarding Privacy of Health Information-HIPAA,
- c. Clinical Professional Agreement for Services
- Telehealth Informed Consent/Agreement for Services: Click here to download
- Release of Information: Click here to download
- Clinical and Professional Agreement for Services: Click here to download
- Notice of Policies and Practices Regarding Privacy of Health Information (HIPAA): Click here to download
- Full Adult Intake Packet: Click here to download
- Full Child Intake Packet: Click here to download
- Provisionally Licensed Full Adult Intake Packet: Click here to download
- Provisionally Licensed Full Child Intake Packet: Click here to download
- COVID-19 Policies and Procedures: Click here to download
- Payment Agreement: Click here to download