Please download the appropriate packet, fill it out and bring it with you to your first appointment.
If you are unable to download or print these forms please contact me and I will have them waiting for you at the office. You will then need to arrive 30 minutes early to complete the paperwork.
Please print out an ROI for each person with whom it would be helpful for me to coordinate care, such as a Therapist, Teacher or Primary Care Physician.
Please review the Privacy/HIPAA statement and the Professional Disclosure statement. They do not need to be printed but should be reviewed. In the packet you will be asked to sign a statement reflecting that you have reviewed these forms.
New Client Checklist:
- Insurance card
- New Client paperwork
- List of medications or actual bottles
- ROI for anyone with whom you would like me to coordinate care
Five things to know before your first appointment
You can download the forms you need to complete before your first visit. Bring the completed forms to your first appointment. If you cannot download and print the forms, you will need to contact my office at 503-679-6470 and let me know to leave the forms out for you to complete. Please arrive half an hour early to your appointment to complete them prior to our meeting
Please bring a list of all your current medications (including over the counter medications and herbal medications) with you to your first appointment. Some patients find it easiest just to bring their medications to the first appointment.
3. Contact Information
Please bring contact information for your primary care provider and your therapist. On this page you will find forms called "release of information" - please complete one for each provider so that I can communicate with your other care providers in assisting providing you with optimal care.
Please bring your insurance card with you to the first appointment. Prior to our first appointment I recommend that you contact your insurance company directly and ask them these billing questions; this way you know prior to our first meeting what your financial responsibilities will be. If I am out-of-network for you, payment in full for services will be collected from you at the time of service. I can bill your insurance as a courtesy or provide you with a receipt to submit for reimbursement directly from your insurance provider. If I am in-network, co-pays and deductibles will be collected from you at the time of service.
Please review my policies before your first visit and review the billing questions. It is my policy that if you need to cancel an appointment that you call me with 48-hour notice so that I have the opportunity to offer the appointment time to another patient. If you do not attend a scheduled appointment or cancel an appointment with less than 48-hours notice, you are responsible for the entire charge for that visit (not the co-pay) as insurance companies do not reimburse for missed appointments. I share office space with other independent practitioners. I am only at my office for scheduled appointments. If you need to contact me, please call 503-679-6470.
I look forward to working with you. I believe that a team approach is best, so I encourage suggestions and full participation by you and your family (if you so desire) in your treatment planning. Thank you!