Client forms
New clients complete a short set of forms before the first session, so the hour is spent on you rather than on paperwork. There are five: an intake, a client information sheet, the Limits of Confidentiality notice, your Good Faith Estimate, and a release of information you only need if records are being shared with someone else.
The forms
- Client Intake
- History, what brings you, and what you want from the work.
- Client Information
- Contact details, emergency contact, and payment information.
- Limits of Confidentiality
- What stays in the room and the narrow situations where it cannot. Required.
- Good Faith Estimate
- Your written cost estimate under the No Surprises Act. Required for self-pay clients.
- Authorization for Release of Information
- Only if you want records shared with a doctor, school or another clinician.
Complete them before your first session and the work starts in the first ten minutes rather than the last ten. If anything on them is unclear or uncomfortable to answer in writing, leave it and raise it in the room instead.
Two of these are not optional
Limits of Confidentiality
Therapy is confidential. Texas law requires a counselor to report suspected abuse or neglect of a child, an elderly person or a person with a disability. Where there is a serious threat to your life or someone else's, Texas law permits a counselor to disclose what is needed to medical personnel or law enforcement, and this practice will. The notice sets out exactly what those situations are. It is better read before you need it than after.
Read the Limits of Confidentiality notice
Good Faith Estimate
Under the federal No Surprises Act, anyone not billing through insurance has the right to a written estimate of what their care will cost, given before treatment starts. Yours covers the expected number of sessions and the fee for each. If the final bill ends up $400 or more above the estimate, you can dispute it.
Blue Cross Blue Shield clients are billed through insurance rather than self-pay, so the estimate works differently; ask in the consult. Fees and insurance in full.
Before you fill anything in
- You do not need the forms to book a consult. The consult is free and commits you to nothing.
- Seeing one of the associates instead? Each associate runs their own paperwork, so ask them directly.
- Send completed forms the way you were told to send them. Email is not a secure channel for clinical detail.
Privacy
The practice's privacy policy covers this website: what it collects, what it does not, and who else sees anything when you visit. How your clinical record is handled is set out in the Notice of Privacy Practices you receive before your first session.
You can ask for your records at any time. Records are provided electronically within 15 business days of a written request, under the Texas Medical Records Privacy Act.
Questions about the paperwork
What forms do I need before my first therapy session?
Five: a client intake, a client information sheet, the Limits of Confidentiality notice, a Good Faith Estimate, and an authorization for release of information if records need to go to another provider. They take about fifteen minutes in total.
What is a Good Faith Estimate and do I get one?
It is a written estimate of what your care will cost, which the federal No Surprises Act entitles you to before treatment begins if you are not billing through insurance. It states the expected number of sessions and the fee for each, and if the final bill comes in $400 or more above it you have the right to dispute the charge.
Do I have to complete the forms before booking a consult?
No. The free consult comes first and needs nothing from you but a few sentences about what is going on. Paperwork only matters once you have decided to start.
Can I email the completed forms back?
Send them by whatever route you were given when the forms were sent. Ordinary email is not a secure channel for clinical information, so ask before emailing a completed form back.
How can I learn more?
The frequently asked questions page collects everything that is not specific to one service: fees and insurance, how the methods differ, complex PTSD, what Texas requires of a counselor, and how to start. If the answer is not there either, a free consult is the quickest way to get one.
This practice does not provide emergency care. If you are in immediate danger, call 911. For a mental health crisis, call or text 988 for the Suicide and Crisis Lifeline.
Start with a conversation
Therapy consults are fifteen minutes. Supervision and EMDR consultation consults are thirty. Both are free and commit you to nothing.