HELPFUL FORMS - theguidedway.net

SCHEDULE A CONSULTATION

If you're a new client, please complete the following forms and bring them to your first therapy session.

Client Psychotherapy Intake Form
Patient Bill of Rights

If you would like me to coordinate care with another provider, such as your psychiatrist or family physician, please complete the following form to authorize the release of your therapy information:

HIPPA Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, click here .

HELPFUL FORMS

4047 Old William Penn Highway

Murrysville PA15668

TEL: 724.733.8313
EMAIL: vze22kad1@verizon.net

CONTACT ME TODAY