At Thriveworks, we often receive requests from counseling providers who are looking for private practice forms (informed consent, intakes, PHI releases, etc). Hence, we have uploaded a few basic forms (PDFs) we have used in our charter counseling office, in Cambridge, Massachusetts. Please note, that we don’t warranty these documents, and you will want to check with your respective ethical boards and state laws before utilizing any part of the following documents. Enjoy! 🙂
- Counseling Client Intake Form
- Counseling Informed Consent Form
- Simple Counseling Receipt for Services
- PHI Release form for Psychological Testing
- Counseling HIPAA Release Form
- Notice of Privacy Practices
- Sample Business Associate Agreement
P.S.: Check out Dr. Anthony Centore’s new Book “How to Thrive in Counseling Private Practice: The Insider’s Guide to Starting and Growing a Counseling Therapy Business”
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Anthony Centore
How can we ptotect ourselves in our home private practice? Is it ok to include on the intake form that we use video doorbell or security cameras?
Also, how do we protect our private practice from being involved in legal obligations? (Child custody/divorce)?
Do you have any examples of private practice social media policies? Or have you included the “benefits, limitations, and boundaries of the use of social media” (as per the Code) in your informed consent?
Christine Finerty