Telehealth Sessions & Forms
Kindly fill out the forms we discussed during our initial telephone contact and bring them to your first session.
- Release of Information Form (PDF)
- YogaTherapy Intake Form (PDF)
- HIPAA Consent Form (PDF)
- NJ HIPPA Notice for Patients (PDF)
- Patient Information Form (PDF)
- Informed Consent for Therapy (PDF)
- Telehealth Informed Consent (PDF)
- Informed Consent for In-Person Services During the COVID-19 Public Health Crisis (PDF)
I look forward to seeing you soon…
- Out-of-state telehealth provider for the State of Florida: flhealthsource.gov/telehealth
- PSYPACT Authority to Practice Interjurisdictional Telepsychology (APIT): psypact.org
