Paperwork for Clients

Online Forms

Please do not complete the client forms unless you have an appointment with me.

Client Intake Form

Collateral Inf Consent

HIPAA Notification

Informed Consent

PDF : HIPAA Notification

PDF : medication List

If you would like to give me legal permission to talk to your doctor, therapist, or other healing practitioner, please complete, and sign the Release Form.

Release Form

If you would like to give me legal permission to talk to your doctor, therapist, or other healing practitioner, please complete, and sign the Release Form.

OPT-OUT OF MEDICARE: PRIVATE CONTRACT

No Surprises Act Forms

No Surprise Consent