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
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.