Ned David Bratspis, PC Tempe, Arizona
Ned David Bratspis, PC Tempe, Arizona
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    • Home
    • About
    • Office
    • Contact
    • Media
    • Forms
    • Workshops
    • Writings
  • Home
  • About
  • Office
  • Contact
  • Media
  • Forms
  • Workshops
  • Writings

Downloadable Forms

Forms

Using The VSee TMH Platform (pdf)Download
Telemental Health Acknowledgement and Attestation (pdf)Download
Telemental Health Informed Consent (pdf)Download
Treatment Planning Collaborative Worksheet (pdf)Download
Close of Washington Practice (pdf)Download
Washington: List of Providers (pdf)Download
Notice of Privacy Practices (pdf)Download
My Therapy Progress Note (pdf)Download
New Client Form Instructions (pdf)Download
Consent to Release Confidential Information (pdf)Download
Health Insurance Claim Form (pdf)Download
Outpatient Services Contract (pdf)Download
TPO - Short Version HIPPA Form (pdf)Download
Psychotherapy Client Questionnaire (pdf)Download
Couple / Relationship Questionnaire (pdf)Download
Informed Consent For MINDFULNESS Based Cognitive (pdf)Download
Therapy Individual / Group (pdf)Download
HEALTH INSURANCE CLAIMS ASSIGNMENT (pdf)Download
No Show Policies (pdf)Download

RelaxingOne.com | Ned David Bratspis, PC

Office Address: Licensed Marriage, Family Therapist | 6625 S Rural Road, Suite 111, Tempe, Arizona 85283

253-514-0525 Fax: (602) 960-6096 HIPAA Compliant

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