Forms

**Please note, these forms do take a while to complete. Be sure to allow yourself enough time to finish so we can begin your first session at the scheduled time. If you prefer to print and complete forms instead, you may do so here.

Couples: Each partner must complete all forms. 

1. Disclosure Statement: Required before beginning therapy. Contract for therapy including rates, cancellation policy, limits to confidentiality, etc.

2. Communication Consent Waiver: Permission to send/recieve non-encrypted electronic communication

3. Client Information Form: The lengthiest of all the forms.

4. Telehealth Consent: This can be signed in addition to the In-Person Consent Form

5. In-Person Services Consent: This can be signed in addition to the Teletherapy Consent Form. 

6. Good Faith Estimate:

 

Couples Good Faith Estimate: In concordance with the No Surprises Act, Medical Professionals are required to provide an estimate for services for all private pay individuals. This form notes estimated prices for duration of therapy. This is not a contract. 

Individual's Good Faith Estimate: In concordance with the No Surprises Act, Medical Professionals are required to provide an estimate for services for all private pay individuals. This form notes estimated prices for duration of therapy. This is not a contract.