Helpful Forms
I am an independent contractor with the Institute for Couple and Family Enhancement (ICFE) and the Information Forms and Consent forms for therapy services can be found via the client portal. Once the intake appointment is scheduled you will receive an email with a link to set up a client portal. The portal will give you access to all the electronic forms to complete prior to meeting.
If you are bringing a minor for therapy, you will complete forms on behalf of the minor, in addition to the forms needed for adults who will be attending with the minor. Please note that signatures affirm that you have the legal authority to consent for treatment of the minor named in the forms. If your legal guardianship is in any way directed by a court order, you will need to provide a copy of the order. You will also need to provide information on custody and guardianship arrangements, and, if applicable, inform the co-parent of the minor’s participation in therapy.
In compliance with the Health Insurance Portability and Accountability Act of 1996 the following is a copy of the Privacy Policies for your review. Please let me know if you have any questions about the management of private health information (PHI).
Notice of Privacy Practice
If you prefer to complete the forms in person, let me know and I can have the forms available to you in our waiting area. Please plan to come 20 minutes early to your appointment if you select to complete the forms in person before the session.
I am an independent contractor with the Institute for Couple and Family Enhancement (ICFE) and the Information Forms and Consent forms for therapy services can be found via the client portal. Once the intake appointment is scheduled you will receive an email with a link to set up a client portal. The portal will give you access to all the electronic forms to complete prior to meeting.
If you are bringing a minor for therapy, you will complete forms on behalf of the minor, in addition to the forms needed for adults who will be attending with the minor. Please note that signatures affirm that you have the legal authority to consent for treatment of the minor named in the forms. If your legal guardianship is in any way directed by a court order, you will need to provide a copy of the order. You will also need to provide information on custody and guardianship arrangements, and, if applicable, inform the co-parent of the minor’s participation in therapy.
In compliance with the Health Insurance Portability and Accountability Act of 1996 the following is a copy of the Privacy Policies for your review. Please let me know if you have any questions about the management of private health information (PHI).
Notice of Privacy Practice
If you prefer to complete the forms in person, let me know and I can have the forms available to you in our waiting area. Please plan to come 20 minutes early to your appointment if you select to complete the forms in person before the session.
