To facilitate a seamless and efficient start to our work together, we ask that you complete the following forms online, print them, and bring them to your initial appointment. To ensure the privacy and security of your information, we recommend submitting the forms in person or via mail. If you prefer to use email, please be aware that it is not a secure platform for transmitting sensitive information. Thank you for your cooperation with this initial process.

Teletherapy Consent Form

 

For Adults:

• Personal Information Form

• HIPAA Informed Consent Form

• Credit Card Authorization Form

• Notice of Mental Health Privacy Practices

• Release of Information Form
   

Upon your therapist's request:

• DBT Individual Client Informed Consent

• Adult Skills Group Agreements

• Skills Coaching Contract
   

For Adolescents and Families:

• Personal Information Form

• Teen Assessment Form

• HIPAA Informed Consent Form

• Credit Card Authorization Form

• Notice of Mental Health Privacy Practices

• Release of Information Form
   

Upon your therapist's request:

• DBT Individual Client Informed Consent

• MultiFamily Skills Group Agreements

• Skills Coaching Contract
   

Diary Cards:

• Adult Diary Card Version A

• Adult Diary Card Version B

• Adult Diary Card Version C

• MultiFamily Diary Card