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.


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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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