Moon

Forms

Here are both digital and printer friendly copies of my forms available. Since I use an electronic health record keeping system, theraplatform, you will sign for these forms virtually. However, I wanted folks to be able to review my forms before working with me, as well as have access to these forms at any time.


I am in network with Blue Cross Blue Shield and Blue Care Network. I also accept cash. Please see my FAQ page and my Fee page for additional information. If you have questions please reach out to contact@truenodetherapy.com.

I am currently redoing this page! (May 2022)

Forms

Release of Information
Release of Information

A window looking out onto a misty background with leaves

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"Fee" Form
"Fee" Form

Shooting star and night sky above a snow capped mountain

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Privacy Policies
Privacy Policies

Ivy crawling up a dark wall

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Consent Form
Consent Form

Pink lotus flower with a blurred dark background

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Intake questions
Intake questions

Waterfall surrounded by lush dark green foliage

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Good Faith Estimage
Good Faith Estimage

Close up image of a pink peony in full bloom

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(B+W) Release of Information
(B+W) Release of Information

Look out a window onto a tranquil blue-green pool with canoes in it and snow capped mountains in the near distance

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(B+W) "Fee" Form
(B+W) "Fee" Form

Black and white image of a misted forrest

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(B+W) Privacy Policies
(B+W) Privacy Policies

Close up of Monstera leaves

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(B+W) Consent Form
(B+W) Consent Form

White Lotus flower fully opens on a black background

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(B+W) Intake Questions
(B+W) Intake Questions

Pink orchids hanging down from a branch against a soothing dark background

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(B+W) Good Faith Estimate
(B+W) Good Faith Estimate

Close up image of white lilies open on a black background

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Hours of Availability

I work Sundays-Mondays and Wednesdays-Thursdays. Currently I see clients from 10 am to 7 pm, as my energy limits permit.

I rest on Tuesdays, Fridays and Saturdays. I do not schedule clients on my rest days. I often do not respond to email on my rest days. Email is the best method of contact.

Questions?

Try the FAQ page