Forms

A number of forms must be completed prior to your first visit. They are provided here if you wish to print them at home and fill them out there, instead of our waiting room. 

I believe strongly in an integrated/collaborative approach to therapy, and as such, will be glad to contact and work with your Physician, Psychiatrist and/ or other healthcare providers. A release of information (ROI) form will need to be signed by you to allow me access to these professionals. I have a close working relationship with many of the Psychiatrist and Physicians in the area. Additionally, I am very familiar with resources in the Central Florida area that may be useful to compliment our work. 

 

Please let me know if you have questions about how this works and/or how it will help your treatment outcome.

 

Forms to be completed:

Client Information Form
This form should be filled out prior to first office visit.

Client Info form

Client Statement of Understanding
Please read and sign this form prior to first office visit.

Client SOU

Client Rights and Responsibilities Notice
Please read this form prior to first office visit.

Rights and Resp.

Receipt and Acknowledgement of Privacy Practices
Please read and sign this form prior to first office visit.

Rcpt. and Ack. Privacy


You will need Adobe Acrobat Reader to see these, if you don't have it, you can get it here