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FORMS
In order to protect your confidentiality, please DO NOT SEND
the completed Life History form to me by email, as it is not a secure
medium. If you wish, you may send the completed form by US Mail
to: 3705 Medical Parkway, Suite 360, Austin, Texas 78705 OR FAX
it to: 512-452-3393.
Additionally, please do not send
emails to this site or to anyone associated with it that may include
confidential information. A link to any other site from this site
does not necessarily imply any approval, recommendation or endorsement
of such site.
Life History Form
The information provided on the Life History
Form can help me immeasurably as I work with you. It can also
help to speed up the process, since you can fill out the form relatively
quickly on your own time rather than providing me with the same
information a little bit at a time.
Download
Life History Form
Informed Consent Information & Form
The information in the Informed Consent Form describes
the ground rules under which I can work with you effectively, ethically
and legally. It is followed by a separate page that amounts to an
agreement between us to accept these rules as the basis of our working
relationship and that permits you to provide me with the information
I must keep in my files.
Download
Informed Consent Information & Form
To
download and print a copy of the Life History Form and/or the Informed
Consent Form you will need to have a copy of Adobe Acrobat Reader
on your computer. Both of these forms can be filled out
on your own computer and then printed, if you have the latest version
of Adobe Reader. This is a free program and if you don't
already have the program on your computer, simply click on the graphic
below to go to the Adobe website to download the program.
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