Psychology Resources

Patient Forms

How to Fill Out Patient Forms

  1. Click the button for the form you need to download and save the PDF.
  2. Open the PDF in Adobe Acrobat Reader.
  3. Select the "Tools" tab.
  4. Select "Fill and Sign" which will allow you to use the cursor to click on the blanks to fill in.
  5. Print the forms and either bring them with you to your appointment or save, scan, and you can submit them via the "Send us a file" button on the right side of the page. *

*second location to upload file, hit "Contact" on bottom right hand of the page, hit the button with 3 lines, and then select "send us a file"


You can also save as a document or image to add a signature that way if it is easier!


You are always more than welcome to print out the form and fill it out with a pen. Once completed, simply bring it with you to your appointment or scan and send it in through the "send us a file" portal.

Don’t have Adobe Acrobat Reader? Click below to download it for free.

GET ADOBE ACROBAT READER GET ADOBE ACROBAT READER

FAQs

  • Do you accept insurance benefits?

    Services are paid by the patient at the time of the appointment. Credit and debit cards, checks, and cash are all accepted forms of payment. Statements will be provided for individuals who choose to file for insurance benefits themselves. Individuals with Medicare insurance must complete the form "Agreement for Medicare Patients" and agree not to submit a claim to Medicare, since I have opted-out of Medicare.

  • Can you prescribe medication?

    No, I am not licensed to prescribe medicine. If it is my clinical opinion that you would benefit from psychotropic medication, I will be happy to work with your family physician or to refer you to a psychiatrist. 

  • Do you conduct evaluations for disability determination, FMLA, or emotional support animals?

    No, I do not conduct evaluations for these purposes.

  • How long are the therapy sessions?

    I normally conduct an evaluation that lasts 2 to 4 sessions. During which time, we can both decide if I am the best person to help you meet your treatment goals. I usually schedule new patients for one session per week. The duration of these sessions is typically 45 to 60 minutes.  As you begin to meet your treatment goals, sessions will be scheduled further apart. Maintenance sessions of 30-minute duration are also available.

  • How do you ensure our sessions are private?

    My office is in a building with various businesses, so it would be difficult for a casual observer to ascertain your purpose in entering the building. I am the only one located in my office and do not have additional staff or clinicians working with me. All patient records are confidential and are not stored online or shared with external businesses such as insurance companies or dictation services.