Reach out to us: 602.508.9190

Forms

Below you'll find the the intake forms for my practice.  Please read through your introductory email to determine which forms are necessary for you to fill out and bring in with you to your first appointment.  I look forward to meeting you!

Client Intake

intake_form_2015.pdf
File Size: 120 kb
File Type: pdf
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Client Re-Intake

reintake_form_2015.pdf
File Size: 73 kb
File Type: pdf
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Limits of Confidentiality

limits_of_confidentiality_2015.pdf
File Size: 27 kb
File Type: pdf
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Treatment Plan & Informed Consent

treatment_plan_2020.pdf
File Size: 65 kb
File Type: pdf
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Policies & Procedures

policies_7_2017_final.pdf
File Size: 165 kb
File Type: pdf
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HIPAA Privacy Practices

hipaa_statutes.pdf
File Size: 110 kb
File Type: pdf
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Release of Information

insurance_consent_to_release_info.pdf
File Size: 49 kb
File Type: pdf
Download File

Amen Checklist

amenchecklist.pdf
File Size: 35 kb
File Type: pdf
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Communications Policy

communications_policy_2015.pdf
File Size: 52 kb
File Type: pdf
Download File