- Disclosure and Agreement for Psychotherapy Services
- Confidential Information
- Acknowledgment of Receipt of Notice of Privacy Practices (please sign after you read the "HIPAA Notice" on this website) .
Please complete these forms as needed:
- Insurance Information (please complete if you wish to use insurance to pay for services) .
- Payment Authorization (please complete if you wish to use your debit or credit card to pay for services).
Please complete this form in the first few weeks of therapy:
Please complete this form if you would like me to coordinate care with outside parties (e.g., psychiatrist, physician, etc.):
This article will help familiarize you with Psychodynamic Psychotherapy. Please read it at your leisure:
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