A Vagabond's Journey Counseling

Documents

Forms to Facilitate Therapy

This packet contains all of the documents that need to be completed before treatment can begin.

This document explains the agreement you are entering into with me as your therapist.  It must be signed for treatment to commence.  I welcome your questions for clarification.

This questionnaire provides information that allows me to know what it is that has brought you to therapy and the factors that have influenced your situation.  Insurance companies require this to demonstrate why your treatment is ‘medically necessary’.

This form authorizes payment for services via your credit card.  This is available if you need to update your form of payment during treatment.  (Unfortunately at this time I cannot process HSA/FSA cards.)

This document provides you with information on how to reach me and the limitations of confidentiality provided by typical means of communication.

It is my duty to protect your privacy and confidential health information. This document explains how I will work to perform that responsibility.

This document is necessary if you need part of your medical record shared with someone else or if you would like someone to have permission to speak with me to support your treatment.