Client Forms
All forms must be completed electronically through the client portal. If you need assistance completing forms, please contact the office so we can assist you. Please feel free to leave blank any areas you do not fully understand, wish to disclose, or do not pertain to you. When you arrive for your initial appointment, we will discuss the forms thoroughly.
***For minor clients. I am required by the Texas Administrative Code to have a copy of any custody agreements or court orders, including adoption decrees before I can see a minor for therapy. Title 22, Texas Administrative Code, Part 30, Subchapter B Rule 681.35 (C) states prior to the commencement of counseling services to a minor client who is named in a custody agreement or court order, a licensee shall obtain and review a current copy of the custody agreement or court order, as well as any applicable part of the divorce decree. A licensee shall maintain these documents in the client’s record. When federal or state statutes provide an exemption to secure consent of a parent or guardian prior to providing services to a minor, a licensee shall follow the protocol set forth in such federal or state statutes.
HIPAA-Notice of Privacy Policy
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully. HIPAA-Privacy-Practices-2021
Complaints
Anyone who wishes to file a complaint against a healthcare professional in this state may call the Health Professions Council toll-free complaint referral system: 1-800-821-3205. This automated, statewide number routes a complainant to the appropriate licensing agency.
