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Before You Arrive

In compliance with the Federal Health Insurance Portability and Accountability Act (HIPAA), there are certain forms that will need to be completed before the end of your first session. The provider you will be seeing will discuss with you how you may get these forms, so that you may complete them before your first appointment.

You may also download the forms from this page, print them out, and bring them with you to your first appointment. Links to the forms are located on the right-hand side of this page.

The first form is a brief intake form Adobe Acrobat icon that allows your provider to gather important information about you that will be needed for both treatment and billing purposes. The second form is an Agreement for Services Adobe Acrobat icon that spells out some of the expectations of the professional relationship, as well as the legal limits to confidentiality. This form has some blanks in it; your provider will inform you of the proper information that should be in the blanks on the form. The final form is a HIPAA Privacy Notice Adobe Acrobat icon that your provider is required to offer to you that details your privacy rights under HIPAA.

Forms

Adobe Acrobat icon All forms require the free Acrobat Reader

Office Location

Washington Psychological Center, P.C.
5225 Wisconsin Avenue, NW
Suite 513
Washington, D.C. 20015
Phone: (202) 364-1575
Fax: (202) 364-0561