Robyn S. Gruber, LPC

Client Information Form - This form gives me information about you and what issues you want to address in counseling. Please print it, fill it out and bring it to your first session.

 

Informed Consent - This gives you information about my counseling practice and what you can expect during treatment. Please print this out and read it carefully. I will go over it briefly with you during the first session, answer any questions you may have, then we will both sign it.

 

Health Insurance Portability and Accountability Act (HIPAA) - This form details the legal duties and privacy practices of the counseling center as well as how your medical and mental health information may be used and disclosed. Please read and print this form and bring it to your first session. Please let me know if you have any questions regarding your protected health information.

 

Release of Information  - This form authorizes me to discuss your treatment with your physician, or anyone other than yourself that you want me to be able to talk with, including your spouse. If you were referred by your physician or psychiatrist, please print this form and bring it to the session with your doctor's name and contact information.