(503) 929-8807
4445 NE Fremont St.
Portland OR 97213

 

Documents

DOCUMENTS

For Counseling and Art Therapy clients:

If you can, please print out the New Client Questionnaire and bring it completed to your first session. I can send it to you by mail in advance of our first meeting if you prefer. Feel free to skip any sections you’re not comfortable with or aren’t sure how to answer.

New Client Questionnaire 2021

Clients Under 18 New Client Questionnaire 2021

I will have the following forms available at our first appointment, and I encourage you to review them ahead of time.

Sally Giles Professional Disclosure Statement 2021

Informed Consent for Treatment 2021

Clients Under 18 Informed Consent for Treatment

HIPAA Notice of Privacy Practices 2021

Authorization for Release of PHI

Telehealth Consent and Release

For Counseling and Art Therapy Supervision clients:

Feel free to review these documents that we will go over in your first session.

Informed Consent for Supervision 2021

Sally Giles Professional Disclosure Statement 2021