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.
Release of Information Consent:
When I need to consult with other professionals about our work together, I will ask you to complete this form. This may be your primary care doctor, or a psychiatrist. This document gives me your written consent to share information about our work together with specific persons whom you designate.