Dr. Sharlene Bird, New York Licensed Psychologist

Forms for Prospective Patients:

Prior to the first consultation, please review the basic forms you will be requested to complete at your initial visit. These documents explain the office procedures and the agreement for psychotherapy services. They also include important information about your confidentiality. Although these are discussed in your first meeting, you may complete the forms prior to coming in.

Adobe Patient-Services Agreement: Informed Consent

Adobe Intake Information

Adobe Release of Information

Adobe EMDR Consent Form

Adobe SE Consent Form

Adobe HIPAA New York Notice Form

Adobe HIPAA New York Psychotherapist-Patient Agreement

Adobe HIPAA Acknowledgement of Receipt

Adobe Informed Consent for Telemedicine Services

Adobe Checklist for Telepsychology Services

Adobe NSA: Rights And Protections Against Surprise Medical Bills

Adobe NSA: Notice and Consent

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