Informed Consent for Telemedicine

This form supplements our Informed Consent for Psychotherapy and the Notice of Privacy Practices; everything in those documents applies here as well — the limits of confidentiality, our fees and cancellation policy, and the rest. Please read this form, raise anything that is unclear or concerning before signing, and sign at the end. You will sign this form electronically; we are happy to provide a copy for your records at any time — just ask.