Client Forms

503-754-3354 bizontherapy@gmail.com

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

Client Intake Form

Information Sheet

Limits of Confidentiality

Information and Consent to Telemental Health

One Page Client Consent to Treat 2019

Notice of Privacey Practices_HIPPA

PP Professional Disclosure 2019




bizontherapy@gmail.com
503-754-3354

verified by Psychology Today


Send a Message

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.