If you have a scheduled telehealth appointment, please print, complete and email the first four forms back to me. Paperwork can also be filled out in person at our office.
- Telemental Health Informed Consent
- Registration or Insurance Registration (if you have BC/BS or ASR)
- Policies and Procedures
- Credit Card Agreement
- Good Faith Estimate
If you would like to coordinate your treatment with another provider, please fill out the following form.