CONFIDENTIALITY

Your patient records are strictly confidential. For this reason no records are released without your authorization. I will ask you to sign a consent for release of information if I feel it may be necessary to contact current or prior treatment professionals, other medical doctors, school, or family. I will also release information if I receive a signed release form from another entity, ie attorney, insurance company. In an emergency situation I will release information that I feel is necessary for your welfare without a signed consent. Please know that I am legally and ethically obligated to break doctor-patient confidentiality in the event of threat of self harm or harm to others or in instances of child abuse or geriatric abuse.

 
 
CONSENT FOR TREATMENT FORM

CONSENT FOR TREATMENT FORM

 
MEDICAL HISTORY FORM

MEDICAL HISTORY FORM