Forms

Before we meet.

Before we meet, please download the Office Policies, the Agreement, and the HIPAA Notice of Privacy Practices Forms to read and keep in your records.

Next, please print the Intake Form, read carefully, complete, sign, and bring to your first session.

Thank you!

OFFICE POLICIES AND AGREEMENT FOR COUNSELING SERVICES

Please read it carefully and keep it for your records. It includes New Outlook's counseling procedures and agreement for counseling services, including Confidentiality, my Social Media Policy, and the Informed Consent.

Informed Consent Form (docx)Download

HIPAA Notice of Privacy Practices

Please read carefully and keep for your records.

HIPAA NoticePrivacyPractices (pdf)Download

Intake Form

Please print, read carefully and complete, sign, and bring to your first session.

Intake History Form (docx)Download

Telemental Health/ Video Therapy

If doing Telemental Health/ Video services, please print, read carefully, and email back to me.

Thank you!

Distance Counseling Informed Consent Form (pdf)Download

Good Faith Estimate

Please read.

Thank you!

Notice for Good Faith Estimate (New Outlook Counseling) (pdf)Download