Before We Meet, Please Read:
POLICIES FORM: My Policies Form explains my office procedures and agreement for psychotherapy services. This form includes important information about your confidentiality. If you have questions after reading this form, I encourage you to bring them up when we meet.
HIPAA: I am required by law to provide you with a copy of the HIPAA Notice of Privacy Practices so you can understand your rights and protections related to the use and disclosure of your identifiable health care information.
Please Complete & Bring to Your First Session:
CLIENT INFORMATION FORM: Prior to our first session, please complete my Client Information Form and bring it to our first appointment. This will help you share important details with me while allowing our first meeting to unfold more naturally.
ACKNOWLEDGMENT OF NOTIFICATIONS: Once you have read my Policies Form and the HIPAA Notice of Privacy Practice form, please sign my Acknowledgment Form. This states that you have access to and have read both forms. Bring this to our first session.
During our Work Together:
THOUGHT RECORD
Sometimes I use Thought Records in my work with clients. If you need extras, you can download this one.
SLEEP DIARY
If you are seeing me for Insomnia, I will have you complete a 7-day sleep diary to track your sleep habits.
AUTHORIZATION TO RELEASE INFORMATION:
There may be times when you and I agree it would be helpful for me to speak with another person to coordinate your care. With the exception of the situations outlined in the HIPAA form, I cannot do this without your written consent. Usually, we will speak about this in person and you will sign the form in my office. However, if you’re unable to meet with me, you may complete my Authorization to Release Information Form and send it back to me.