The following are packets of forms for clients to fill out for their first appointment. The first two packets are for someone seeking counseling services. The third is for someone seeking psychological testing services, and is for both children and adult clients.
The following are forms which clients may be asked to complete during the course of treatment regarding issues of privacy and confidentiality.
Release of Information – this form is used to give us permission to communicate with people or agencies outside of Still Waters. Information is never given to anyone else without this form being completed.
Release of Confidentiality – This form is used when you decide to take information with you, such as a psychological testing report or a letter of attendance (for excused absence from school or work). Since you have total control over what you do with the information, this form releases us from being responsible for that specific piece of paper. However, this form does not mean we can give that information out without your permission! We would still need the Release of Information filled out for that.
Release of Information – Substance Abuse Services – The laws about confidentiality are somewhat different for substance abuse services, and this form reflects those differences.
Communication of PHI – This form is used to give permission for staff to contact you via phone, email, or video conferencing. It is essential for anyone receiving Telehealth services.
Questions Regarding Forms? Email us at contact@still-waters-counseling.com
