FORMS

Forms are for established clients, students, or registered participants only.

Please complete the required forms before your first scheduled intake appointment or the date of your program event.

To schedule an appointment, an initial screening must take place. If you are not an established client but are interested in my services, please reach out on the contact page.

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iNFORMED CONSENT FORM

STEP 1 OF 3 FOR NEW CLIENTS

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Client intake FORM

Client intake form

STEP 2 OF 3 FOR NEW CLIENTS

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NO SURPRISES ACT/GOOD FAITH ESTIMATE (GFE) FORM

no surprises act / GOOD FAITH ESTIMATE (GFE) FORM

STEP 3 OF 3 FOR NEW CLIENTS

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standard authorization of disclosure FORM

standard authorization of disclosure form

CONSENT FORM TO COMMUNICATE WITH ANOTHER PROFESSIONAL OR AGENCY

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evaluation FORM

EVALUATION FORMS ARE SUGGESTED TO BE COMPLETED FOR STUDENTS WHO HAVE PARTICIPATED IN A PROGRAM THAT CE’S WERE NOT OFFERED OR THE STUDENT DID NOT NEED THEM

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COACHING FORM

Coaching form

CONSENT TO PARTICIPATE, RELEASE, AND WAIVER OF LIABILITY

participant agreement, informed consent & release of liability

PARTICIPANT AGREEMENTS ARE TO BE COMPLETED BY ANYONE ATTENDING A CLASS, WORKSHOP, RETREAT, TRAINING, TEACHER TRAINING OR ANY OFFERED PROGRAM EITHER ONLINE OR IN PERSON.