FORMS
The following is a list of various documents and forms which you may view or print. The forms with an asterisk (*) are the forms I ask my clients to review and fill out prior to our first session. To view, click on the titles in bold. You may print these documents in the same manner as you would for any other document.
*Client Disclosure for Psychotherapy Services
All clients who receive treatment services from me must read and sign this form. You may wish to review this prior to our first session, but we can go over it together before you sign it. This form is sometimes called an informed consent and includes information on your rights and responsibilities as a client, my fees and office policies and general information about my practice education and training.
All clients who receive treatment services from me must read and sign this form. You may wish to review this prior to our first session, but we can go over it together before you sign it. This form is sometimes called an informed consent and includes information on your rights and responsibilities as a client, my fees and office policies and general information about my practice education and training.
* Client Intake
This is a standard questionnaire I ask my clients to fill out prior to our first session. Please fill this out and bring it with you.
This is a standard questionnaire I ask my clients to fill out prior to our first session. Please fill this out and bring it with you.
* Somatic Consent Form
I practice somatic (body-oriented psychotherapy) and sometimes this might involve healing touch, but only with a client's informed consent.
I practice somatic (body-oriented psychotherapy) and sometimes this might involve healing touch, but only with a client's informed consent.
What Do You Hope For in Therapy
People come to therapy for personal reasons. This is not a required form, but it could be helpful in getting our therapy work off to a good start.
People come to therapy for personal reasons. This is not a required form, but it could be helpful in getting our therapy work off to a good start.
Women's Support Group
This agreement is to be signed by each member of the 6-week Women's Support Group.
This agreement is to be signed by each member of the 6-week Women's Support Group.
Release of Information
This is the form you will need to fill out and sign in order for me to communicate with other parties. If you already know that you want me to communicate with certain people, you need to print this page and have it ready for when you come in. Examples of others you would like me to communicate with or receive records from include: medical providers, insurance providers, other therapists, or family.
This is the form you will need to fill out and sign in order for me to communicate with other parties. If you already know that you want me to communicate with certain people, you need to print this page and have it ready for when you come in. Examples of others you would like me to communicate with or receive records from include: medical providers, insurance providers, other therapists, or family.
Trauma Treatment & Dissociative Disorders
This information is offered to give you important information about your treatment and provide you with an informed basis with which to understand the benefits and potential pitfalls in the treatment of traumatic and dissociative disorders
This information is offered to give you important information about your treatment and provide you with an informed basis with which to understand the benefits and potential pitfalls in the treatment of traumatic and dissociative disorders
