info@daniellegreenelmft.org
(707) 840-4672

info@daniellegreenelmft.org (707) 840-4672 info@daniellegreenelmft.org (707) 840-4672 info@daniellegreenelmft.org (707) 840-4672
Home
Schedule an appointment
First Visit
FAQ's
Contact me

info@daniellegreenelmft.org
(707) 840-4672

info@daniellegreenelmft.org (707) 840-4672 info@daniellegreenelmft.org (707) 840-4672 info@daniellegreenelmft.org (707) 840-4672
Home
Schedule an appointment
First Visit
FAQ's
Contact me
More
  • Home
  • Schedule an appointment
  • First Visit
  • FAQ's
  • Contact me
  • Home
  • Schedule an appointment
  • First Visit
  • FAQ's
  • Contact me


Before Your Visit


Before being treated each client MUST HAVE filled out and turned in the following forms:

  

A) Patient Information

B) Informed Consent Signature Page

C) HIPAA Signature Page


Insurance Verification


If you would like me to verify coverage with your insurance company please submit the Insurance Verification Form to me before you schedule your appointment. 


PLEASE DO NOT EMAIL ME YOUR FORMS


Due to the unsecured nature of email and the potential of exposure of your health information to the wrong parties please return your forms by mail or drop it office at my office by sealing forms in an envelope and placing it under the door.  You can wait to hand in additional paperwork at your first appointment.


Minor Clients


As per California law, BOTH parents signature of authorization to treat any minor (17 years age or less) OR a copy of legal documentation authorizing one parent to make sole medical decisions is required.





Forms

Insurance Verification form - PDF (pdf)

Download

Client_Information Form- PDF (pdf)

Download

Informed Consent Form - PDF (pdf)

Download

Telehealth Consent Form - PDF (pdf)

Download

HIPAA -PDF (pdf)

Download

Copyright © 2022 Danielle M. Greene, LMFT - All Rights Reserved.

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