Forms
This document serves as "Informed Consent" and includes a Disclosure Statement, Notice of Privacy Practices, Fee Agreements, Communication Agreement, and policies of my therapy practice.
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Telehealth Disclosure Statement
Clients must give written consent to participate in telehealth for therapy treatment. This documents outlines the nuts and bolts of telehealth in addition to information about the risks and benefits of telehealth.
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Release or Receipt of Information
Also referred to as an ROI, this form is to be used for any verbal or written disclosure of confidential client data and can only be requested by the client.
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Therapy Appointment is an easy-to-use, HIPAA-compliant online platform for storing Electronic Medical Records, appointment scheduling, billing, confidential email and more. Please set up a client Therapy Appointment account after we have had a phone screening and have agreed to move forward and work together.
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No Surprises Act and Good Faith Estimate Disclosure