Before your first session, please read the following documents: |
- Policies: My Client Information and Policies document explains my qualifications and approach, office procedures including types of payments and insurances I accept, and confidentiality. If you have questions about anything in this document after reading it, please bring them up at your first meeting with me.
- Telepsychology Services: Additional Information and Policies explains the benefits and risks of telepsychology, confidentiality related to telepsychology, technical issues, and fees.
- Electronic Communications: My Electronic Communication Policy document describes my policies regarding our potential interactions on the Internet and via cell phone. If you have any questions or concerns about these policies, please discuss them with me when you have your first session, or you can call or email George before your session to ask.
- HIPAA: My Notice of Privacy Practices explains your rights and protections related to the use and disclosure of your identifiable health care information.
Please print, complete, and bring to your first session: |
- Insurance Information: Prior to our first session, please fill out the Insurance Information and Medical Assignment form, except for your signature and the date. This form describes the payment arrangements that will apply to our working together. Once I’ve answered, in our first session, any questions you might have about this form, you can then sign and date it, and then send it to me.
- Client Information: Please also fill out my Client Contact Information and Permission form before our first meeting; it includes spaces for your address, phone numbers, email address, and so forth, and lets you give your consent about which ways it’s OK for me to contact you. My receiving this information in writing prior to your first session will help our first meeting flow more smoothly. If you have any questions or concerns about this form, you can wait to sign and date it until your first session, and then send it to me.
- Receipt Acknowledgement: Finally, please complete (except for your signature and date) my Receipt Acknowledgement and Consent Form before we first meet. It allows you to state that you’ve received all the relevant documents from me, and had the chance to ask me any questions about them. Once I’ve answered, in our first session, any questions you might have about any of the informational documents and forms, you can then sign and date it, and then send it to me.