Forms to Complete
Intake Forms
Your initial intake form will be available in the Jituzu client portal after you are sent an invite to the portal and set up your user identification and password.
Your initial intake form will be available in the Jituzu client portal after you are sent an invite to the portal and set up your user identification and password.
Professional Disclosure and Notice of Privacy Practices
These documents summarize my training, credentials, fees and cancellation policies. It reviews the limits of confidentiality and provide details regarding your privacy rights in keeping with the Health Insurance Portability and Accountability Act. These documents will need to be printed and signed before the start of our first session. The Professional Disclosure and Notice of Privacy Practices will be provided for signature prior to your first appointment.
These documents summarize my training, credentials, fees and cancellation policies. It reviews the limits of confidentiality and provide details regarding your privacy rights in keeping with the Health Insurance Portability and Accountability Act. These documents will need to be printed and signed before the start of our first session. The Professional Disclosure and Notice of Privacy Practices will be provided for signature prior to your first appointment.