Documents

Psychotherapy Clients:

Please print and sign (may be electronically signed) and return by encrypted email, snail mail, or dropped off at my office.

  1. Client Registration Form ‐ ClientRegistrationForm_SDavis.pdf
  2. Client Rights and Responsibilities ‐ ClientRightsAndResponsibilities_SDavis.pdf
  3. Client’s Informed Consent ‐ ClientsInformedConsent_SDavis.pdf
  4. Consent To Telemedicine Services ‐ ConsentToTelemedicineServices_SDavis.pdf
  5. COVID Notice ‐ COVIDNotice_SDavis.pdf
  6. Disclosure Document ‐ Disclosure-Document.pdf
  7. HIPAA Notice of Privacy Practices ‐ HIPAANoticeOfPrivacyPractices_SDavis.pdf
  8. Treatment Collaboration Information Release Authorization ‐ TreatmentCollabInfoReleaseAuth_SDavis.pdf

Bodywork Clients:

Please print and sign (may be electronically signed) and return by encrypted email, snail mail, or dropped off at my office.

  1. Confidential Client Case History (aka: “Intake Form”) ‐ Confidential-Case-History-3-1-18-1.pdf