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Suzanne Ivey, PhD. (now retired)
To assure that you are fully informed about the nature of your therapist's practice, to protect your confidentiality, and to access information that may be useful in making our time together most efficient, we are putting in this section downloadable copies of the forms most frequently used in our practice. Not all the forms will be relevant to your particular situation, but this will make them more available to you if/when you and your therapist together decide, for example, to request records from prior treatment or to communicate with a physician who might be prescribing medications.
Of all the forms listed in this section, the only one we strongly encourage you to read before your first session is the Patient Therapist Agreement, so you have time to consider the information before you decide to proceed.

You will need Adobe Acrobat Reader to download a printable copy of the form. If you do not have Adobe, just click on the link below to download and install a free copy.



Patient Therapist Agreement

Insurance Form

Primary Care Physician Prescriber Coordination of Care Form

Information Release Form