Forms

 

For individuals starting therapy, please complete and sign the following forms, and email completed forms via secure email at amy@amylynngerber.com

Consent for Treatment 
Fee Agreement
Client Intake Form
Credit Card Authorization
Notice of Privacy Practices (keep for your records)
Acknowledgement of Receipt of Privacy Practices

For couples starting therapy, please complete and sign the following forms:

Couples Consent for Treatment
Couples Fee Agreement
Couples Intake Form
Credit Card Authorization
Notice of Privacy Practices (keep for your records)
Acknowledgement of Receipt of Privacy Practices