NEW PATIENT FORM

This form asks you to provide some demographic information, medical treatment history, and psychiatric treatment history, to review during our first session. 

• Initial Biographical Form for Adults

NOTICE OF PRIVACY PRACTICES

Privacy is a very important concern for all those who come to my office.  This Notice of Privacy Practices describes how I protect your personal health information (PHI), tells how I may use and disclose your clinical information, and explains certain rights you have regarding this information.  I am providing you this notice in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and I will comply with the terms as stated.  You can obtain a copy from me at any time, and it will be posted here on my website.  Please return a signed copy of the Notice of Privacy Practices Acknowledgment Form on the last page of the document to your initial appointment. 

• HIPAA Notice of Privacy Practices