Forms

BEFORE WE MEET
If you are a new client, please complete the following forms and bring them to your first session:
Insurance Information
Insurance Information Form.

If you plan on using your BC/BS insurance, I will need the Insurance Information form completed before our first session so that I can verify your benefits. Experience has taught me to verify benefits before the first session to avoid any “surprises” (some policies have different co-pays/co-insurance amounts for mental health than for medical health, some policies are contracted out to insurance companies that I am not contracted with, etc…), which can unnecessarily complicate things and take the focus off of treatment and instead put in on financial matters.

Basic Information
Basic Information Form.

If you do not plan on using insurance, please complete the Basic Information form.

Consent to Release Form
Consent to Release Form.

If you have other mental health care/physical care providers (such as a psychiatrist, primary care physician, etc…) that you would like me to coordinate care with, please complete this form.

Questionnaire
Questionnaire Form.

This is a questionnaire that, while lengthy, will save us 4-5 sessions of my asking you all of these questions. If there is anything that you are uncomfortable answering, please feel free to leave it blank.

Social Media Form
Social Media Use Form.

This document outlines my office policies related to use of Social Media.

Services Agreement
Credit Card Form
Consent for Teletherapy
Consent for Returning to In-Person Therapy