Informed Consent, Therapist-Client Agreement, and Policies: PDF

Form

Health Insurance Portability and Accountability Act

The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral.

Learn more about HIPAA

Sliding Scale/Reduced Rate Application

Please complete the following form to inquire about a sliding scale rate or reduced rate. If approved, you will receive a percentage off of the practice amount according to financial need in accordance with federal poverty guidelines.

Application

Update Credit Card

Please use this form to update your card on file.

Update Card