Counseling

Initial Paperwork 

You can save us time by downloading & completing a few files as described below, then bring them to our session. If you prefer, feel free to email or fax them to me prior to our meeting.

Please find your category for instructions. 

… for Individual Work

If you are 15 or older, complete a FM Policies & HIPPAA Consent, a FM Contact Information & Billing Authorization, a FM Client History, and an FM PHQ & MDQ Surveys. A parent completes these for anyone under 15.

If you want or need me to provide/request information about you to/from another person or agency, then please use Release of Information.

… for Relationship/Family Work

One person completes a FM Contact Information & Billing Authorization including the name, birth date, & any separate address information for each person who will attend any sessions.

Each person (15 and over) who will attend any sessions reads, initials, and signs a FM Policies & HIPPAA Consent. Each person (15 and over) who will attend any session completes a FM Client History and a FM PHQ & MDQ Surveys.

If anyone attending sessions wants or needs me to provide/request information about you to/from another person or agency, then use Release of Information.