Authorization to Treat and Notice of Privacy Practices, Explanation of Treatment Process, Explanation of Treatment Using Multi-Sensory Trauma Processing with Job-Related and Other Multiple Traumas and other forms for New/First Time Patients can be downloaded, reviewed and filled out prior to your first appointment, allowing more time for treatment.

These files are in .pdf format. If you don't have Adobe Logo Adobe Acrobat Reader to view these files, click HERE to download it.

Health Insurance Portability and Accountability Act (HIPAA) requires that I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of Protected Health Information (PHI) for treatment, payment, and health care operations. State laws and professional ethics require that a new patient read and understand his/her rights in seeking and agreeing to treatment. The required forms are quite long, however it is important that you read and understand them. Treatment is more effective if you understand the type of treatment that is being provided, communicate openly with your therapist and understand your rights.

New/First Time Patients:

  1. Read: Authorization to Treat and Notice of Privacy Practices, fill out and sign Acknowledgment of Review of Notice of Privacy Practices (including how to contact you) at the end of the document and bring with you to the first session. Note any parts that you do not understand or want to discuss further.
  2. Read: Explanation of Treatment Process. Note any parts that you do not understand or want to discuss further

  3. If you are interested in treatment for job-related trauma and/or multiple personal traumas, read Explanation of Treatment Using Multi-Sensory Trauma Processing with Job-Related and Other Multiple Traumas. Note any questions you have about this treatment to ask in the first session.

  4. Fill out and bring to your first session:
    • Patient Intake Information form
    • Insurance or Workman’s Compensation form (If you have CareFirst BlueCross/BlueShield) or are filing a work claim.
    1. Download Directions to Office
    2. Dr. Davis will review the documents you read with you during the initial session and have you sign Consent for Treatment Form after this discussion.

    Rev 11/08/03