Client Resources

This page has legal, clinical, and technical information for my clients. I recommend bookmarking it, so you can come back to it as needed.


Informed Consent

Click here (PDF opens in new tab) to view and download the Informed Consent. This document contains information about my online psychotherapy services and business policies. Your signature represents an agreement between you (the client) and me (the clinician). It must be signed and emailed back to me before we can begin therapy. You can use an electronic signature, or you can print it out, sign and scan, then email it back.

The document also contains a Consent for Electronic Transmission of Protected Health Information, which is required for online therapy.


Intake Form

If you are seeking individual therapy, click here to complete the Intake Form for Individuals.

If you are seeking couples therapy, click here to complete the Intake Form for couples. Both of you must complete your own separate intake.

This online questionnaire will help me get to know you and understand your reasons for seeking therapy. Depending on how detailed you choose to be, it should take around 10 to 20 minutes to complete. Please submit it before our first session together — ideally at least one day before, so I have time to review it.

The information you submit is private and confidential. Please refer to my Informed Consent (see above) for details on keeping your health information secure.

If you prefer a paper form that you can fill out by hand, let me know. Just be aware that the process of completing and sending it back may take longer with paper.


Video Call Logistics

Click here to review some technical information for online therapy. Please make sure you have your technology set up and ready to go well before the start of any session.


Payment Options

My supervisor, Pam Shaffer, collects payments on my behalf (please see my FAQ for information about the supervisory relationship). Here are the payment options she offers:

Venmohttps://venmo.com/Pam-Shaffer

Please send payment after each session. Include the date of service with an emoji of your choosing to help us keep track of billing. You can also friend Pam on Venmo for easy reference.

PayPalbestselfpsych@gmail.com

Please send payment after each session. Pam prefers if you send via the Family and Friends option to avoid fees.

Credit Card

Please complete the Credit Card Authorization Form (PDF opens in new tab) beforehand and email it back to me. If you don’t feel comfortable sending your credit card information via an email attachment, please fill everything else out, sign and return to me, and then I can take your credit card number over the phone. Your credit card will be charged after each session and will appear on your statement as Metalalia Media.