New Client Documents
All new clients must print, complete, and bring the following two documents to their first session, and read the Notice of Privacy Practices (found at the bottom of this page).
Ecclesiastical Assistance Form
If you are utilizing ecclesiastical assistance, you must also complete the following form and bring it to your first session.
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Bishop's Authorization for Payment of Services
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Additional Client Documents
These forms do not need to be printed out or brought to your first session.
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Client Authorization for Disclosure of
Confidential Information This form is provided for clients who wish to authorize me to discuss confidential information and client history with former therapists, counselors, doctors, or other individuals specified by the client.
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Client Authorization for Disclosure of
Proteted Health Information This form is provided for clients who may choose to disclose protected health information to a third party
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Notice of Privacy Practices
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Clients must read this document prior to signing the Informed Consent
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