Forms

 

P1010047

In order for us to make the best use of our time together, it is helpful  if you look over the documents listed below prior to our first meeting.  Many clients like to preview and complete these documents before the first session (you can download and print out these forms and have them with you at our first meeting) while others prefer to complete them in person at our first meeting.  Do not sign any forms that are unclear or about which you have questions.  Feel free to bring a list of your questions with you to our first session.   Click on each link below to access the following forms.

 GENERAL FORMS

Family/Child Professional Disclosure & Consent Form 2017

By law, all psychologists use consent forms that provide information regarding credentials, payment policies, and legal and ethical issues.  This form must be agreed to and signed in order for us to work together.  Do not sign the form until you feel comfortable with the information, and be sure to let me know of any questions you might have about it.

Family:Child Consent Form 2017

Adult/Couples Psychotherapy Professional Disclosure & Consent Form 2016  (under revision, coming soon)

By law, all psychologists use consent forms that provide information regarding credentials, payment policies, and legal and ethical issues.  This form must be agreed to and signed in order for us to work together.  Do not sign the form until you feel comfortable with the information, and be sure to let me know of any questions you might have about it.

HIPAA 2017

This explains your rights regarding your protected health information. Please read it carefully so you understand what situations I may need to disclose information. 

Family Work Client Intake

I will provide you with a link to this form after we have scheduled our first appointment.  This form will provide me with background information about your child and family.  Some people like to spend a lot of time on this questionnaire, while others are brief or prefer to communicate information verbally.  Feel free to answer it at your level of comfort.

Individual Psychotherapy Client Intake

I will provide you with a link to this form after we have scheduled our first appointment. This form provides me with background information about you.  Some people like to spend a lot of time on this questionnaire, while others are brief or prefer to communicate information verbally.  Feel free to answer it at your level of comfort.

Couples Psychotherapy Client Intake 

I will provide you with a link to this form after we have scheduled our first appointment.  This form provides me with background information about you.  Some people like to spend a lot of time on this questionnaire, while others are brief or prefer to communicate information verbally.  Feel free to answer it at your level of comfort.

Release of Information    Release of Information LynnCollins

This form allows me to have contact with another professional in order to provide you and your family with the most informed care.  If you would like me to talk to another professional such as a teacher, doctor, therapist, etc., you will need to complete this form.  If I speak with another professional, I will let you know the content of that conversation.  Also, even if I have a general Release of Information, I will let you know when I communicate with another provider.  I will also provide copies of any written materials shared with other providers, and will consult with you prior to sharing them.