If you have already spoken with us about becoming a new patient and scheduled an initial evaluation appointment, you can fill out the initial paperwork from the convenience of your home or office. This saves you the hassle of having to arrive early at our offices to complete these forms.
Although the time may vary by person, it generally takes 15-20 minutes to complete these forms.
These forms must be completed in order for us to be able to meet with you. Completion indicates your informed consent to treatment. If you have not completed the forms in advance or made arrangements with your provider to fill out the forms immediately before your appointment, we will ask you to do so during your appointment time which will reduce the remaining face-to-face meeting time available.
Client Information Packet, Spiegel Psychological Services (All Providers)
Notice of Privacy Practices, Spiegel Psychological Services (All Providers)
Authorization to Communicate with your Referring Health or Mental Health Procvider, Spiegel Psychological Services (All Providers - Only Applicable for Referrals)
Authorization of Insurance Benefits, Spiegel Psychological Services (All Providers - Mandatory for in-network insurance; Do Not Complete if out-of-network)
[Required, please choose applicable form for your provider]: