If you are a new client please review and complete forms prior to your first appointment.
Client Forms
Intake Assessment Form
Please complete this form prior to your first session. It informs Katie about you, your history and your counseling goals and needs.
Agreement for Services
Review and complete this document prior to your first session. It contains information on services, fees and privacy details. Virtual sessions are carried out via Spruce.
Agreement for Services & Informed Consent
Release of Information
If you would like Katie to speak with anyone (e.g., primary care physician, psychiatrist, etc) regarding your treatment, complete this document and bring to your first session.
HIPAA Notice of Privacy
Review and complete this document prior to your first session. It contains information on how your private medical information is used and accessed.
HIPAA Notice of Privacy Practice
Email/Text Informed Consent
Please review and complete this document covering sensitivity of email and SMS/text communication prior to your first session.
Email & Text (SMS) Messaging Informed Consent
Electronic Payment Authorization
Download and complete this form if you intend to pay for session fees via credit card.
Electronic Payment Authorization
Good Faith Estimate
Health care providers are required to provide a Good Faith Estimate for current and prospective clients who are private pay or uninsured.
All forms are available in pdf format from Acrobat Reader. Here is the link to install Acrobat Reader for free.