Carole Vance, Licensed Marriage & Family Therapist

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Forms

The following forms can be completed ahead of time or at the first session. They are standard forms for the client's protection as well as for the basic needs of therapy.

1. Intake Form. This form can be completed, then either emailed to carolevance@ymail.com or printed and brought

    to the first session. This form (as with all medical records) is kept confidential  Intake Form

2. HIPAA Form. This form is for the client's records. It explains medical record privacy laws   HIPAA Form

3. Receipt of HIPAA Form: This form indicates that the client has received HIPAA Privacy Laws (#2). It can be 

    signed, then emailed to carolevance@ymail.com or printed and brought to the first session. 

     Receipt of HIPAA Form