Please fill out the Client Packet on your computer and save the form to your computer desktop. Then email the completed form to me at firstname.lastname@example.org.The additional forms are provided on an as needed basis.
The credit card information is used to bill a client only in the event that the client does not comply with the cancellation policy. Clients will be charged without providing 24 hours advance notice to cancel a session. It is unlikely that the therapist can fill an appointment for Monday that is canceled over the weekend. If an appointment is scheduled for a Monday, the client must cancel by the preceding Friday prior to 4PM or the client will be charged.
Please bring the method of payment with you to the session and if you choose to use a credit card, the card will be processed at that time in the traditional manner.
If you think that you may want me to consult with a teacher, a physician, or another family member at sometime please also fill out the Consent to Release Information Form. You may revoke this consent at anytime you wish.
You will need adobe reader to view and fill out the forms. In case you do not have adobe reader you can download it here for free.
For your convenience, the Client Packet is a compilation of the forms below. By filling out the Client Packet completely you will not need to complete the forms below.
Once you have filled out the Client Packet please Save the Client Packet to your desk top and email the form to me at email@example.com