At your first session, we will review the following informational forms. Please complete these prior to our meeting so that we have ample time for discussion and get to know how we might work together.
Client Information This is a personal demographics questionnaire and you are encouraged to answer in a way that best reflects you.
Client History This space is to share your past and present experiences as you see them relevant to our work.
Acknowledgements and Signature Page This acknowledges that you have read the HIPPA documentation, my informed consent policy, and my Social Networking and Contact Policy (found below). I am happy to answer any questions about these forms.
The following forms are for your reference.
HIPAA Information This form explains your privacy rights as a client.
Informed Consent This document provides information about confidentiality and my therapy policies includes a signature page.
Social Networking and Contact Policy This document describes my policies on how we can communicate around and in between sessions, and on how I interact with social networking sites.
If your experience and the areas in which you seek support are not listed here, I encourage you to contact me for an initial consultation to see how we might work together.
Office Location: My office is located in Hayes Valley and convenient to public transit including Civic Center BART station, the Van Ness MUNI stop and the bus lines 5, 21, 47, and 49. There is easy access to the central freeway and street parking is available. The building has elevator access and is walking distance to a village of shops, restaurants and parks.
Office Information: 459 Fulton St., Suite 105, San Francisco, CA 94102
Phone: (415) 937-0425
I am a registered psychological assistant, PSB94021587. Supervised and employed by Dr. Rachel Robbins.