916-936-3960

111 Natoma St, #101 Folsom, CA 95630

Forms

Please download, print, read, and sign these forms prior to our first session so that we do not have to use our meeting time to cover them in their entirety. I will give you a chance to ask questions about them before you return them to me, so you feel aware of what the informed consent and intake process entails.

 

If we are meeting in my office, please bring your printed, signed forms with you to our first meeting.

If we are meeting online, you will need to upload a digital copy of your signed forms and save them to the computer you will be using for our online therapy appointment. You will be able to return them to me electronically from that computer during that session.

These forms are grouped into two categories: items to read and items to sign/complete. Please take your time with the items to be read first, make sure that you understand them, and then sign that consent on the forms to be signed. You only need to return to me the forms that need to be signed. This is also a heads up that the “Client Information Form” may take you up to half an hour to complete.

 

Forms to read if we are meeting in my Folsom office:

Folsom Office Policies and Therapy Contract

Folsom Electronic Records and Billing Disclosure

Folsom Notice of Privacy Practices

Folsom BBS Letter for Couples and Families

Forms to sign if we are meeting in my Folsom office:

Folsom Client Information Form

Folsom Acknowledgement of Notifications and Agreement to Policies

Folsom Nonsecure Communications Consent Form

 

Forms to read if we are meeting online:

Online Office Policies and Therapy Contract

Online Therapy Informed Consent Form

Online Electronic Records and Billing Disclosure

Online Notice of Privacy Practices

Online CA Proof of Licensure

Forms to sign if we are meeting online:

Online Client Information Form

Online Acknowledgement of Notifications and Agreement to Policies

Online Nonsecure Communications Consent From