INTAKE FORMS

If you are interested in scheduling a session, the following disclosures and forms must be reviewed prior to the start of the first session. You are able to ask questions regarding any aspect of your treatment at any time. In most situations, consent is valid for up to one year from the start of treatment or can be withdrawn at any time. Please notify your therapist either verbally or in writing if you wish to withdraw any consent, verification or payment method:

- Intake demographics: Your contact information and what is the presenting issue that brought you to therapy

- HIPPA (Health Insurance Privacy and Portability Act): This is the Federal guidelines regarding confidentiality. Best practice is to always use the most restrictive form of confidentiality. It protects you and helps you understand what is private.

- Payment/fee schedule: Insurance is accepted using third party scheduling and payment options. Private pay sessions are preferred through IvyPay app via credit or debit card. Other forms of payment are accepted (PayPal, Venmo, CashApp). An invoice is generated for you to pay through credit card and a receipt is issued that you can use to be reimbursed through a Health Savings Account.