CLIENT FORMS

Please make sure to review and sign these forms at least 24 hours prior to your first appointment. Para formularios y documentos de admisión en español, haga clic aquí.

Practice Policies

Privacy Practices

Consent For Treatment Via Telehealth

In Case Of Emergency

Informed Consent: Lauren Reminger

Informed Consent: Alba Hernandez

It is our policy to have a credit card on file. Your card will automatically be charged at the time of service.

Payment Information & Authorization

To increase transparency in healthcare billing as required by the “No Surprises Act”, effective January 1, 2022.

Good Faith Estimate For Health Care Items & Services: Lauren Reminger

Good Faith Estimate For Health Care Items & Services: Alba Hernandez

Please complete, sign and return this form if you would like to authorize the release of Personal Health Information.

Authorization For Disclosure of Health Information

Consent For Telehealth Consultation

Consent For EMDR Treatment

Consent For Observation

Consent For Treatment Of A Minor

Reduced Fee Application

Getting Started With Teletherapy