Lancaster Psychotherapy
313 W. Liberty Street, Suite 223
Lancaster, Pennsylvania 17603

Forms you can download

The following forms can be downloaded for you to fill out and bring to your first appointment. I can also give you these forms to fill out at our first appointment. Please read the lengthy Notice and Privacy Practices (NPP) on the Confidentiality and Privacy Practices page before our first appointment

Client Information Form
This form asks for basic information I need to have about you as my client

Payment Agreement Form
This form explains my payment policies with my clients

Electronic Communications Form
This form explains the use of electronic communications in our work together

Medication and Supplement Form
Please list medications and supplements you are taking on this form

Notice of Privacy Practices (NPP) Consent Form
This consent form acknowledges that you read or reviewed the Notice of Privacy Practices at the start of our work together. The NPP is on the Confidentiality and Privacy Practices page

Safety Practices Relating to COVID-19 Form 
This consent form explains certain safety practices that my client and I agree to follow relating to COVID-19

Telepsychology Informed Consent Form
This form explains the benefits and limits of online therapy sessions. Please read and sign this form if you plan to have any online sessions with me