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Blue Mountains
Blue Mountains

Helpful Forms

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If you're a new client, please view my welcome letter, my curriculum vitae, and then complete the following forms and bring them to your first session.

  1. Consent to Treatment Agreement Form
  2. Adult Information Form OR
  3. Child Information Form
  4. HIPAA
  5. Release of Information Form (Used only if you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), then complete this form)

 

Welcome letter  
CV  
Adult Info Form  
Child Info Form  
Release of Info Form  
Disclosure and Treatment Form  
HIPAA  
Electronic Comm Policy  

Note: To download Adobe Acrobat Reader for free, click here.

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Helpful Forms

Click here to view and print forms for your appointment.

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