Thanks for your interesting in becoming a client of our practice.
Now that you've been in contact with one of our therapists, please fill out the following paperwork in advance of your initial appointment.
- Notice of Privacy Practice - (All providers; Required)
- Client Information Packet - (All providers; Required)
- Psychologist-Client Agreement - (Spiegel; Required)
- Psychologist-Client Agreement - (Krigel; Required)
- Credit Card Agreement - (All providers; Required if you want to use credit card)
- HIPAA Authorization to Release Information - (All providers; Required if you want us to electronically submit out-of-network claims for your sessions to your insurance company on your behalf)
- Release from Liability for use of Clinical Hypnosis - (Spiegel; Required if you will be integrating clinical hypnosis into treatment)
- Authorization to Communicate with a Health or Mental Health Provider - (All providers; Optional)