Please read these forms.
You do not need to print these forms.
- HIPPA & Disclosure Statement
- Risks to Your Confidentiality with Email and Texting
- Electronic Payment Communications Disclosure
Please PRINT and complete the following forms and mail them to my office or you can EMAIL them to [email protected]
*Note: Email is not encrypted and therefore not confidential. Please read the Electronic Communication Disclosure above.
- Therapist-Client Agreement & Julie's Policies
- Consultation Agreement
- Intake Paperwork
- Consent for Non-secure Communications and Social Media
If you are a distance client, please sign this form as well as the forms above.
- Online Video Meeting Instructions and Tele-health Consent
- Video Call Quality Troubleshooting Tips
- Trouble Shooting Sound Quality Issues
-
Privacy Tips
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.