Forms

Below are the forms that you will need to fill out before arriving for your first session. Please print the Assignment of Benefits, the signature page only of the Psychotherapy Consent, and the completed Intake Form. They will download in PDF format. Please let me know if you’d prefer that I mail these forms to you.

Assignment of Benefits

HIPAA – New York Notice Form

Psychotherapy Consent

Intake Form

Informed consent for Telepsychology

 

 

FOR ADDITIONAL LOCAL RESOURCEShttp://www.hvpa.org/index.asp