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Forms for Clients

Please click on the link below to access the respective form

HIPAA Notice
This notice describes how psychological and medical information about you may be used and disclosed, as well as how you can get access to this information. It also describes the limitations of the confidential nature of our therapeutic relationship.

Information for Clients Brochure
This brochure contains important information about our relationship in therapy. After you have read it, we will discuss any questions and concerns that you have. I will then ask you to sign a separate “Consent to Treatment” form indicating that you have read and fully understand the content of this brochure.

Consent to Treatment Form
Your signature on this form indicates that you willingly agree to enter into therapy under the conditions that we agree upon and that you may terminate therapy at any time you choose.

Consent for Body Oriented Psychotherapy Form

Your signature indicates that you understand what and how body-oriented methods and interventions may be utilized in our work and that you willingly agree to enter into body-oriented psychotherapy. 

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