New Clients

Please print out and complete the first four forms listed below before our first appointment. Please complete the Authorization for Disclosure Form if you want me to talk with someone about you (e.g., your physician). The Notice of Privacy Policies is for you. The Credit Card Authorization form is only necessary if all sessions will be via telephone and you want to pay via credit card. If you want to pay via credit card and your sessions are in person I do not need this form.

If you have any questions, please call 916.990.7733. Thank you, and I look forward to working with you!

 

New Clients

Office Policies and General Information

Client Information Form

Symptom Checklist

Therapy Consent Form

Authorization for Disclosure Form

Notice of Privacy Policies

Credit Card Authorization

 

 

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