I look forward to our first session together and hope we can maximize our time together by completing required paperwork ahead of time.  Please refer to the "Requested Action" column below to identify which forms I would like you to read, complete, sign and bring with you to our first meeting.  You can then click on the name of the individual form, in the "Form" column, to print.  If you have any questions about any of the information included in these forms, please be sure to ask me and I will be happy to clarify. 

Thank you very much!

 

FORM

DESCRIPTION

REQUESTED ACTION

Mandatory Disclosure Statement

Information required by the State of Colorado Please review, sign and bring with you to our first session

Notice of Privacy Practices

Information required by HIPPA Please review and save

Notice of Privacy Practices Receipt

Acknowledges your receipt of the Notice of Privacy Practices Please review, sign and bring with you to our first session

New Client Information

Basic information about you Please complete and bring with you to our first session

Credit Card Authorization

Allows me to process your payments via credit card Complete, sign and bring with you to our first session ONLY if you plan to pay by credit card

Consent for Release of Information

Allows me to share and/or exchange confidential information with other parties For future use as needed, we will review, discuss and sign at that time