Downloadable Forms & Other Info

Client Information Form

Download this 2-page, printable Client Info (PDF) form to provide information about you.

Fee Schedule & Polices

Printable Fee Schedule & Polices (PDF) form.

HIPAA Notice of Privacy Practices

Printable HIPPAA Notice of Privacy Practices (PDF) form.

APA Informed Consent Checklist for Telepsychology Services

Printable APA Informed Consent Checklist for Telepsychology Services (Dr. Joan Fiorello) (PDF) form.

Good Faith Estimate

Printable 1-page document about your right to receive a GOOD FAITH ESTIMATE (PDF).