PRIOR TO OUR FIRST MEETING, I NEED THIS INITIAL INFORMATION SHEET AND THE INFORMED CONSENT TO TREAT FILLED OUT AND SIGNED.

IF WE ARE MEETING IN PERSON, YOU CAN FILL THESE OUT AT THE OFFICE IMMEDIATELY BEFORE YOUR APPOINTMENT.

IF WE ARE MEETING VIRTUALLY, PHONE OR VIDEO, I NEED THESE COMPLETED AND RETURNED TO ME PRIOR TO OUR APPOINTMENT TIME.

INITIAL INFORMATION

INFORMED CONSENT TO TREAT

1638 N Coast Hwy, Newport, OR

(Sea Towne Shopping Center - 2nd Floor)

541.819.2121

 Tuesdays & Thursdays

Appointment Times: 1230 until 630pm

Mondays, Wednesdays & Fridays

Appointment time:  530pm

If you are in the mental health field and like the style of my website, I'd be happy to help you create your own professional website.  Please give me a call at 541.819.2121 and we can talk about details.