Forms to Complete
Notice of Privacy Practices
This document provides you with important information about Bellingham Family Counseling’s policies and practices in keeping with the federal Health Insurance Portability and Accountability Act (HIPAA). Please sign this form in recognition of receipt of this document and bring it to your first appointment
This document provides you with important information about Bellingham Family Counseling’s policies and practices in keeping with the federal Health Insurance Portability and Accountability Act (HIPAA). Please sign this form in recognition of receipt of this document and bring it to your first appointment
|
Print and sign
|
| |||
Intake Forms
This document provides important information related to your physical and mental health history. Please fill it out and bring it to your first appointment
This document provides important information related to your physical and mental health history. Please fill it out and bring it to your first appointment
|
Print and sign
|
| |||
Professional Disclosure
This document summarizes my training, credentials, and cancellation policies. It reviews the limits of confidentiality. This document will need to be signed before the start of our first session.
This document summarizes my training, credentials, and cancellation policies. It reviews the limits of confidentiality. This document will need to be signed before the start of our first session.
|
Print and sign
|
| |||
|
| ||
| safety_and_care_plan.docx |