Printable Forms

The following is a list of important client forms. The forms marked required will need to be completed before I can begin providing psychotherapy services. You can choose to download and complete these forms at home to save time, or you can fill them out in the office. If you have any questions about the forms, you can ask in person, or contact me.

Forms For My Practice at H.O.P.E. Psychotherapy of Houston

Signed Divorce Decree or Signed Adjudicating Parentage Decree (Required if patient is a minor under 18, with divorced parents. Send to me well before the first session, so I can determine if both parents need consent.)

Consent for Services (Required)
New Patient Questionnaire (Required)
New Patient Forms (Required)
Notice of Privacy Practices (Required)
Emergency Information (Required)
Email Consent (Required)
Authorization to Release Information Form
Teletherapy Consent
Sliding Scale Form

 

*Note* All forms are in PDF Format. Click Here to view PDF files using Adobe Reader.

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