Forms

BEFORE YOUR FIRST VISIT YOU WILL NEED:

  1. Office Policies Statement—It is important that you read this before proceeding. If you are a couple, you should both read this.
  2. Intake Form—Each of you can fill out an Intake Form on your computer. Print out and bring the completed forms (one for each of you) to your first session.
  3. Privacy Practices—This HIPAA form is for your records.
  4. Office Directions
  5. Couples Questionnaire

AFTER WE HAVE MET, YOU MAY NEED:

  1. Release of Information—to allow me to communicate with another health care provider
  2. Video Consent
  3. Medicare Contract