Please click on the links below to access relevant forms:
Client Information PLEASE COMPLETE
Updated Notice of Privacy Services Please Keep copy for your records
HIPAA acknowledgment of receipt please sign
Medical history Please print and complete
Presenting Concern Adult Self-Report Please Complete
At the start of therapy, each client is asked to review and sign a copy of Consent to Treatment, which is a shortened version of the original Comprehensive Consent to Treatment (with the goal of saving trees). By signing the shortened version, each client consents to the stipulations and conditions of the Comprehensive Consent to Treatment, which can be accessed below or requested directly from Dr. Ostoja.