Forms

The following documents provide useful information about my practice. Please review them before our first session:

        Information for Clients Handout: This form outlines my practice policies and my approach to therapy.

        Notice of Privacy Practices: As per HIPAA, this document describes the manner in which your confidential         health information will be handled.

 

Please complete the following documents and bring them to your first session:

      Forms for Adults: 

        Adult Intake Information Form

      Forms for Children:

        Child Intake Information Form

        Affirmation of Parental Right to Seek Treatment

        *Parents who are separated or divorced, or are planning to separate or divorce, please also complete the         following form:  Agreement for Seperated or Divorced Parents

 

Additional information that may be of interest:

        Client Bill of Rights

        Information you have a right to know: A list of questions you may want to ask me or any other therapist         before deciding to work together

        Limits of the therapy relationship

        Insurance Coverage Questions: This form has questions to ask your insurance carrier to determine your         benefits. I encourage you to obtain this information before your first session if you plan to submit for         reimbursement of therapy charges.

 

Psychology News

 

Books and Websites Coming Soon 

Houston Family Psychology, LLC
Dr. Ehrin Weiss
Clinical Psychologist
Texas Licensed Psychologist

9525 Katy Fwy, Suite 200 Houston, TX 77024
Dr. Weiss, of Houston Family Psychology, LLC, shares a suite with Krummel and Associates, PC, and other independent practitioners.
Phone: (713) 263-0400 ext. 205
Fax: 713-263-0333
Email Me

 


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