New Client Forms
Please click the button below to download the New Client Intake Packet. All forms in this packet must be filled out in full, and signed, by the time of our first session. Additionally, please click the button below to review the Notice of Privacy Practices: Client Rights & Responsibilities before filling out the intake forms.
Release(s) of Information
Please click the button below to download a blank copy of my Release of Confidential Health Information (ROI). A signed ROI is needed for me to speak with others about your care with the exceptions of me contacting emergency services on your behalf or to file a mandatory report about abuse or neglect. We will review this policy in detail during our first appointment and as needed throughout treatment.
Professional Disclosure Statement
New clients will be asked to read my Professional Disclosure Statement (PDS) and sign a document stating that you have read the form and understand how to contact the Oregon Board of Licensed Professional Counselors and Therapists
Privacy & Security
Please click the button below to review the American Psychiatric Association’s policies regarding privacy and health information technology (HIT)
COVID-19 Safety Information
Telehealth sessions offered via phone and/or video at any time.
Snapdragon Counseling Services meets or exceeds all state and federal guidelines regarding the COVID-19 pandemic.
6 ft. social distancing standards are followed on-site.
Masks are required for all persons on the BG Plaza premises, including the Snapdragon Counseling Services office and waiting room.
The office is sanitized before and after all sessions; The building is cleaned every night between Monday and Friday.
Sanitation supplies are available for client use as needed.