Forms & Info

Please download and fill out and bring these forms with you when we meet.
 
New Client Information:

Please complete this form so that I may have some basic information about you before we begin.

 

Informed Consent for Treatment and Personal Disclosure Statement:

This document describes my practice and policies with regard to my professional qualifications, approach to treatment, fees, scheduling, cancellations, and consent for treatment. When you sign this form, you are stating that you consent to my services and policies as described in the disclosure statement.

 

Notice of Privacy Practices Statement:  

Your confidentiality is important to me. This form explains my policies related to this as well as the few exceptions to privacy. Washington State law requires that I provide clients with contact information for the Department of Health should you have any complaints against the services I provide. When you sign this form, you are stating that you have received this document.

Telehealth Disclosure & Consent Addendum

This document is provided in addition to Pamela Woodroffe’s Informed Consent for Treatment & Personal Disclosure Statement in order to provide you with some specific information about your participation in telehealth counseling services.

Lake City Professional Center

2611 NE 125th Street, Suite 206
Seattle, WA 98125


LICSW, SUDP, MAC, CCTP
Psychotherapist for adults in Seattle

© 2020  P Woodroffe PLLC dba Woodroffe Counseling Services.  All rights reserved.