Welcome ~ I look forward to meeting you.
We’ll be able to maximize our time together if you complete the new client packet, sign the policies statement and bring in release forms from your current providers.
Please download the appropriate packet, fill it out and bring it with you to your first appointment.
- New Client Packet Adult (18-64)
- New Client Adolescent (11-17)
- New Client Packet Parent/Guardian of (11-17)
- Office Policies and Fee Schedule
If you are unable to download or print these forms please contact me and I will have them waiting for you at the office. You will need to arrive 30 minutes early to complete the paperwork.
Please print out a ROI for each person with whom it would be helpful for me to coordinate care, such as a Therapist, Teacher or Primary Care Physician.
Please review the Privacy/HIPAA statement and the Professional Disclosure statement. They do not need to be printed but should be reviewed. In the packet you will be asked to sign a statement reflecting that you have reviewed these forms.
New Client Checklist:
- Insurance card
- New Client paperwork
- List of medications or actual bottles
- ROI for anyone with whom you would like me to coordinate care
Six things to know before your first appointment
One of the most important ingredients to your feeling better is what you yourself bring to our professional relationship. Your desire to get better and curiosity about what sorts of things will help you improve, along with the relationship we form as teammates in your healing are every bit as vital as any medication or technique that I may offer during our work together. Please bring hope and I’ll meet you with expectancy!
Please download the forms you need to complete before your first visit. Bring the completed forms to your first appointment. If you cannot download and print the forms, please contact my office at 503- 523-9629 and let me know to leave the forms out for you to complete. Please arrive 30 minutes early to your appointment to complete them prior to our meeting. Print off the 3 page Policies and 14 page New Adult Packet . You will not need to print off separate copies of the disclosure, ROI’s or HIPAA forms unless you wish to keep a printed copy for your records. Be thorough and candid this will hasten your care and allow us to focus on what you want to talk about rather than filling out paper work during your visit.
Teens – I am really interested in what you have to say about you. Please fill your set of forms out on your own. Your parent/s will do their forms and we’ll work together.
Please bring a list of all your current medications (including over the counter medications and herbal medications) with you to your first appointment. Some patients find it easiest just to bring their medication bottles to the first appointment. Also write down any previous medications and side effects or helpfulness that you experienced with them.
4. Contact Information
Please bring contact information for your primary care provider and your therapist. On this page you will find forms called “release of information” (ROI) – please complete one for each provider so that I can communicate with your other providers in order to provide you with optimal care. Two ROI’s are included in your New Client packet – one for your Primary Care Provider and one for a provider of your choice. If you need to include additional therapists or providers, print off extra forms. If there are important people in your life and they are not mentioned on your forms, please write them down.
Prior to our first appointment I recommend that you contact your insurance company and ask them the previous listed billing questions. Payment in full will be expected from you at the time of service. You can pay with cash, check, debit or credit card. Please bring your insurance card with you to the first appointment. I will copy it in the event I need to communicate with your insurance company.
Please review, print off and sign my policies before your first visit. It is my policy that if you need to cancel an appointment that you call me with 48-hour notice so that I have the opportunity to offer the appointment time to another client. If you do not attend a scheduled appointment or cancel an appointment with less than 48-hours’ notice, you are responsible for the entire charge for that visit. I will excuse one missed appointment per year, as long as you notify me in advance. If you need to contact me, please call (503) 523-9629.
I look forward to meeting you. We’ll review your history and discuss some of what you hope to accomplish. Please bring your questions and concerns. If we don’t cover everything at our first meeting and you decide to work together with me, we can continue our exploration at your next appointment.
Write Down Your Questions
Feel free to write down any questions you have ahead of time and check my FAQ page for some answers to common questions.