Forms

Are you scheduled for your first appointment? We're looking forward to meeting you! Here are your next steps:

1. Fill out a Standards and Policies form. Click on your counselor's name below. If you are coming in as a couple, both partners should sign this form. (**If you are seeing Carolyn as your counselor, you also have the option to consent to audio or video recording of your sessions).

2. Fill out an Intake form. Click on the one that applies to you (individual adult, couple, adolescent, child).

3. Fill out our COVID-19 Disclosure form. This form is ONLY needed if you are coming for an in-person appointment. If you are coming in as a couple, both partners should sign this form.

4. Fill out the Payment Authorization form at the bottom of this page.  Once our office administrator receives this form, the information will be entered into Therapy Notes, our practice and billing software, and this form will be deleted. Once the information is entered into Therapy Notes, we no longer have access to the actual credit card information. We only know the last four digits. We will run this card for your session charges unless you contact us before your session to request that we use another card or form of payment. We accept HSA cards and all major credit cards except American Express. We also accept cash and checks if your appointment is in the office. If you prefer not to complete this form, please be prepared to give your credit card information to your therapist at the beginning of your session.

We use JotForms as our platform for making paperwork easier and more streamlined for you. Rest assured that all of these forms are HIPAA compliant and fully secure. Paper copies are available if you prefer. Please ask your therapist about this. If you have any questions, call us! 512-258-5100

Standards and Policies

Click on your counselor's name. This will take you to the appropriate Standards and Policies form which you can fill out online. These forms are HIPAA compliant, so rest assured that your information is protected.

Intake Forms

Click on the intake form below that best applies to you. Fill it out online. These forms are HIPAA compliant, so rest assured that your information is protected.
 

COVID-19 Disclosure

Coming in for an in-person appointment? Here's what you need to know about your Personal Health Information (PHI). Please read this form, sign it, and you'll be good to go! Let us know if you have any questions.

We have also posted information about how we're making this as safe as possible for you. Read our COVID-19 page to learn more.

Payment Authorization

Need to pay for your appointment? Here's the form. You can either opt for a one-time payment or allow us to store your card on file in an encrypted format in TherapyNotes, our software system. After we complete the payment and/or store your card, we delete this information.

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