Please print, complete and bring with you to your first appointment: 

1) Therapy Policies (for your type of provider) ; 

2) Intake Registration Form; and

3) Privacy Practices Informed Consent Form.

1.  THERAPY POLICIES and CONSENT FORMS

          

Psychologist Therapy Policies & Consent

BPG Clinical Social Worker Policies & Consent rev 4-20

2. INTAKE REGISTRATION FORM

                         

Intake Registration Form

3. PRIVACY PRACTICES INFORMED CONSENT FORM

                 

Privacy Practices Informed Consent

Please read our Privacy Practices Notice: 

Privacy Practices Notice-Summary

 

Privacy Practices Notice-Complete

LOCATION & CONTACT INFORMATION

Address:  1525 NE Weidler St., Suite 101, Portland, OR 97232

Telephone:  503.287.7006        FAX:  503.287.0212