Click on the link below to download each form.
Complete, sign and return to amyrpaul.lpc.pc@hushmail.com.
Thank you.
- Consent to Use and Disclose PHI
- Informed Consent to Treatment
- Telehealth Informed Consent
- Payment Agreement
- Authorization to Release Confidential Records and PHI
Please read and retain a copy of the Notice of Privacy Practices for your records.