If you're a new client, please print, review and sign the following documents and bring them to your first session.
Client Information and Consent
Telepsychology Consent
Signature Page
Please review the following documents regarding Lake Minnetonka Psychology, PLLC Privacy Practices and the Minnesota Board of Psychology client bill of rights
MN Notice of Privacy Practices
MN Board of Psychology Client Bill of Rights
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.) complete this form to authorize release of psychotherapy information:
Health Care Release of Information
If you would like me to coordinate care with a school agency (for example, obtain school records, communicate with a classroom teacher), complete this form to authorize release of educational information:
Educational Records Release of Information