Deborah L. Carle, Ph.D., LLC Licensed Psychologist

PAPERWORK MUST BE COMPLETED PRIOR TO APPOINTMENT TIME OR YOU WILL NEED TO RESCHEDULE.

Informed Consent and Professional Services Contract

HIPPA Privacy Statement (only signature page needed)

Non MD Disclosure

Report to Primary Care Physician

Credit Card Authorization

Adult Registration Form

Adult Registration for Returning Clients

Child/Adolescent Registration Form (to be completed by parent/guardian)

Adolescent Paperwork (to be completed by children 12-18)

Release of Information (optional)