Forms

The buttons below will take you to our online forms that will be processed through our secure, HIPPA approved servers and sent directly to Jeff Nelson, LSCW.

Treatment Exclusions Form
Telemental Health Informed Consent
Surprise/Balance Billing Disclosure
Release of Information
Informed Consent
HIPAA Form
HIPAA Form Privacy Practices
Consent to Treatment and Recipient's Rights
COVID-19 Waiver Form
Client Information Form
Client Admission Form
Disclosure, Treatment & Fee Agreement Form

Pychotherapy Services

grief + loss therapy | mood disorder therapy | self-esteem issues | substance abuse | gay + lesbian
physical and sexual abuse survivors | relationship therapy | cognitive behavioral therapy

1805 South Bellaire Street, Ste 219 | Denver, CO 80222 | 303.408.9658 | Contact