©2017 by Zach Sikora, Psy.D.

PATIENT FORMS

Please print, review, and complete the following forms before arriving for your initial appointment. Please write down any questions you have while completing the forms and we can discuss them during our initial meeting.

PRIVACY PRACTICES

This document includes your rights with respect to personal health information and the privacy practices of health plans and me as a health care provider.

OUTPATIENT SERVICES CONTRACT

This document outlines the nature of my services, both clinical and financial, as well as the limits of confidentiality.

PATIENT REGISTRATION

This document is a registration form that includes your contact and insurance information.

SOCIAL MEDIA POLICY

This document outlines my policy regarding interacting with patients via social media.