If you wish, you can print out and complete the following forms to bring with you to your first appointment. I will also have these forms available for you at my office.
- Patient Information Form
- HIPAA Notice of Privacy Practices
- HIPAA Acknowledgement
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, OB/GYN, etc.), complete this form to authorize release of information:
- Release of Information Form
|Patient Information form|
|HIPAA Noticeof Privact Practices|
|Release of Information Form|
Note: To download Adobe Acrobat Reader for free, click here.