Forms
In order to use our time most effectively, I ask that you read the following forms prior to our first session. You are welcome to contact me with any questions regarding these forms.
- Patient Agreement, Authorization, & Consent for Treatment
- HIPAA Notice of Privacy Practices
- Technology, Electronic Communication, and Social Media Policy
- Scheduling & Attendance Policy
- Billing & Insurance Policy
- Basic Info and Acknowledgement of Policies
- Anxiety & Depression Assessment
- Authorization to Release Information
Video Sessions:
Video sessions may be offered to established patients if appropriate,
Jennifer S. Hartman, Ph.D. is a Licensed Psychologist with the Texas State Board of Examiners of Psychologists TX License #32123. For information on how to verify a license, please click here for the Texas State Board of Examiners of Psychologists (TSBEP) website. For information on how to file a complaint, please click here for a PDF flyer or please click here to be directed to the complaint page on the TSBEP website.
