On this page, you will find some of the documents you may have been asked to review, complete, and return.
These documents are locked and you will need the security code I have provided to you in order to view and/or download.
Once downloaded and completed, you can bring them with you to your session or you can return them by encrypted email or secure fax (813) 448-1040.
If you prefer to return the documents by email, please do not do so using ordinary email. Instead, please email me at: email@example.com and let me know you would like to email your documents and I will reply with an invitation to use an encrypted email platform. This is to add a layer of security to protect your confidential healthcare information and we will continue to use that platform for all future email correspondence.
The document “HIPAA Agreement” should be reviewed, and the last page should be signed and brought to your consultation. If I have not already provided you with the password to unlock this document, or if you have any questions or concerns about the document, please call or email me so we can discuss this further.
If you have arranged with me to have sessions using telephone or video conferencing, please download the Telepsychology Informed Consent document to review, sign/date and return prior to your initial consultation.
The following documents are to be downloaded only after your initial consultation with me. You will need to use the password that I provided you in your initial consultation to access these documents. It is very important that you review these documents carefully and sign any appropriate consents that are attached. We will review these together at your next session and if you have any questions, I will address them at that time.
Please print out the document “Client Information Form” and complete it for our next session.
The document “Client Agreement & Consent” you may either save to your computer or print. The last page of that document, however, must be printed, signed and returned to me at our next session.
If you will be working with me as a couple, please review, sign/date and return prior to your initial consultation.
Informed Consent for In Person Services During the COVID-19 Public Health Crisis
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