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Policies and Practices to Protect the Privacy of PHI
Policies and Practices to Protect the Privacy of PHI
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Complete these forms to avoid arriving to your initial COUNSELING appointment 10-15 minutes early.
Complete these forms to avoid arriving to your initial LIFE COACHING appointment 10-15 minutes early.
Copy of the Non-Discrimination Policy.
To be completed if you want your provider to communicate with another person about your confidential information.
Details concerning professional services.
To be completed after your first LIFE COACHING session. Your provider will have this form available for you before session if you do not have one already completed.
To be completed if you want your provider to communicate with another person about your confidential information.
Complete these forms to avoid arriving to your initial LIFE COACHING appointment 10-15 minutes early.
Details concerning professional services.
This form re-affirms your rights concerning your personal information and our assurances to handle it properly.
Copy of the Non-Discrimination Policy.
Telehealth Informed Consent Screenshot
Telehealth Informed Consent
Easy Pay Informed Consent
816 N William Application
Complete these forms to avoid arriving to your initial COUNSELING appointment 10-15 minutes early.
To be completed before your counseling or coaching session.
Ideas for preparing for telehealth
Some ideas for preparing for telehealth
Professional Counseling Fact Sheet
Important Phone Numbers
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