GENERAL FORMS
ALL PATIENT FORMS
NEW CLIENT FORM
ACKNOWLEDGEMENTS
CONSENT TO TREATMENT
MEDICATION REFILL REQUEST
NOTICE OF PRIVACY PRACTICES
OUT OF NETWORK CLAIM FILING AGREEMENT
RELEASE OF INFORMATION
SELF-EVALUATION FORMS
PHQ-9
GAD-7
EPWORTH SLEEPINESS SCALE
ADULT ADHD SELF-REPORT SCALE
ALL INFORMATION IS KEPT STRICTLY CONFIDENTIAL
Clinical information is kept either physically secure or on a secure, encrypted web server which is compliant with U.S. federal health information technology standards (HIPAA)
Absolute confidentiality is assured. Information is only shared under the following circumstances:
- Under the client’s direction & written consent
- For the coordination of emergency health care where obtaining proper consent is either impossible or would cause such a delay that harm would ensue
- To guard against imminent danger to the safety of an adult or child
- Under the direct order of a judge or court
For more information, download our complete privacy policy, above.