New Client Questionnaire
This questionnaire aims to get to know you better and provide the best possible mental health treatment. Please complete this form as honestly and thoroughly as possible. As required by state and federal law, all information you provide me will be confidential.

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, respecting the client’s legal rights and allowing her/him/them to make an informed decision about participating in the treatment. The ethics code and the licensing laws and regulations of mental health professionals also require the informed consent process.

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 regarding the use and disclosure of your Protected Health Information (PHI) for treatment, payment, and healthcare operations. HIPAA requires that we provide you with a Notice of Privacy Practices (the Notice) for using and disclosing PHI for treatment, payment, and healthcare operations.