New Client Intake Paperwork

2, 3, 4, and 6 must be printed out to complete and brought to your initial session or mailed to my new mailing address (coming soon).

 

1) Good Faith Estimate Notice (for yourself only)

2) Client Information Form (print and return)

3)Outpatient Contract (print and return)

4) Video Telehealth Consent Form (print and return)

5) HIPPA Notice (for yourself only)

 

6) HIPPA Notice Signature (print and return)