How to use these forms: Download and print each PDF, complete them by hand, and bring the signed copies to your first session. All forms are letter-size (8.5" × 11"). If you have trouble printing, Sandy can provide copies at the office — just arrive a few minutes early.
Required — Please Sign & Return at Your First Session
Professional Disclosure & Consent for Treatment
Sandy's qualifications, services, fees, confidentiality policy, and the terms of your therapeutic relationship. Required reading before your first session.
HIPAA Notice of Privacy Practices
Explains how your protected health information may be used and disclosed, and your rights as a client under the Health Insurance Portability and Accountability Act.
Consent & Acknowledgment Signature Sheet
Your signed acknowledgment that you have read and understood the Professional Disclosure Statement and HIPAA Notice. All clients must sign before beginning treatment. Families and couples — each member signs separately.
Client Information Form
Basic contact information, areas of concern you'd like to address, health history, and how you found Sandy's practice. Please print legibly.
Cancellation Policy
Sandy's policy on appointment cancellations and the 24-hour notice requirement. A $150 fee applies to late cancellations and no-shows. Please read carefully and sign.
Additional Form — Complete if Requested by Sandy
Adverse Childhood Experiences (ACE)
A clinical questionnaire about experiences before age 18. Sandy may ask you to complete this as part of her intake process — your responses are confidential and help guide your care.
Questions about a form, or trouble accessing the downloads? Sandy speaks with every new client personally before scheduling.
(803) 787-3130
Voice mail is confidential.