For New Patients

Next Steps

The following 3 documents are required for beginning therapy with me. For privacy reasons, please print out and complete as a paper and pen documents and bring them to your first visit with me. Please do not return any of these forms to me via email.

These documents are meant to give you some information on what working with me entails, and helps to set some rules and expectations for both of us in our therapy relationship.

Breakdown of Documents

Introductory Information - This 9-page form will be reviewed during our first meeting. It includes the following important points for potential clients to understand:

• Benefits and potential risks of therapy
• Format & duration of treatment
• Therapy with me
• Expectations of treatment
• About confidentiality ("Notice of Privacy Policy")
• Appointments & cancellation policy
• My relationship with insurance companies and other entities involved in your care
• Fees, payment, and billing
• How to file a complaint

It also collects some information about you for me to keep on file, including:

• *Permission to call emergency contact and other members of your medical treatment team
• *Permission to send an appointment reminder
• *Verification of understanding the rules, including the confidentiality policy

Consent to Treatment - This is a 1-page agreement to engage in treatment with me.

Client Information Form - This is a 1-page form allowing me to get some basic information about you, including:

• Concerns bringing you to therapy
• Your background
• Medications and other treatments
• Your goals