New Client Questionnaire
This questionnaire is for the purpose of getting to know you better in order to provide the best possible mental health treatment. Please complete this form as honestly and completely as possible. All information that you provide me will be confidential as required by state and federal law.

Policies and Procedures
Please take a few moments to read and complete this document, which describes my professional therapeutic services and business policies. It also contains summary information about privacy and confidentiality guidelines.

Adolescent Informed Consent
I ask that this form be reviewed by the parent(s)/guardian(s) with the adolescent present and engaged in the review.  Informed consent lays the foundation for the psychotherapy relationship and treatment to come in respecting the client’s legal rights and offering her or him the opportunity to make an informed decision about participating in the treatment to be offered. The informed consent process also is required by the ethics code and in the licensing laws and regulations of mental health professionals.

HIPAA Privacy Authorization Release of Information
The Health Insurance Portability and Accountability Act (HIPAA), is a federal law that provides privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that we provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations.