Specializing in Emotional Transformation Therapy (ETT™)
Same Day Appointment Possible • Individuals and Couples Over 18 • LGBTQ Welcomed
I invite you to use our time together for therapy instead of paperwork, so please download, print and complete these forms before your first appointment.
Scan and email the BACKGROUND INFORMATION form back to me 24 hours before your first session. Bring BOTH completed hard copies of the forms WITH YOU TO THE FIRST SESSION.
If you prefer that I learn this information through conversation with you and fill the forms out for you as we go, I will be happy to do that, as well.
FORMS REQUIRED BY FEDERAL REGULATIONS AS WELL AS FOR BACKGROUND AND EFFICIENT USE OF CLINICAL TIME TOGETHER :
(ONE-SESSION PTSD RESOLUTION CLIENTS USE THIS
BACKGROUND FORM INSTEAD)
HIPAA PRIVACY POLICIES • READ ONLY
CONSENT AND NOTIFICATIONS
MEDICARE INFORMATION (IF APPLICABLE) •
with scans or photos of both sides of insurance card,
then print form and bring to first session