Your therapist or our office manager may ask you to fill out one or more of the forms below and bring with you to your appointment. You may also fax forms to us at: (651) 493-9335. If you have any questions, please email us at firstname.lastname@example.org.
Release of information and telehealth forms
- Authorization to Release & Disclose Information
- Telemental Health Therapy Policy and Informed Consent
- Neurofeedback Progress Assesment (to be used only after therapy sessions)
Please be mindful of sending confidential information via email. We encourage you to call us at (651) 493-9335 if you have questions or have any issues with the forms on this page.