Forms

Please read through the forms below prior to our session. In this section you will find a form called a Colorado Notice Form. This a therapeutic agreement clearly outlining both of our responsibilities as we enter into the therapeutic relationship.

You will also find a form called Release of Medical Information. I will ask you to sign this if you are intending to use insurance to pay for part of your costs related to psychotherapy.

Please be assured that I will use utmost discretion in disclosure, limiting claims to include date of service, diagnosis, and as generic description of the session as is ethically appropriate. Your rights regarding confidentiality are outlined, including any limits to privacy.  Please ask me any questions you have regarding these forms.

Download Forms Here

Authorization to Release – PDF or Word document

Colorado Notice Form 2013 – PDF or Word document

Confidentiality – PDF or Word document

Disclosure and Information – PDF or Word document

General Practice Information – PDF or Word document

Signature Form – PDF or Word document