Forms

Below you will find links to the forms that you may be required to print, read, complete and bring to your first session with Dr. Berry.

If you have any questions about the content, please don’t hesitate to query Dr. Berry.

Authorization for Disclosure of Protected Health Information:

Below you will find a link to the Authorization for Disclosure of Protected Health Information Form.

Click Here to download the disclosure form.

Forms for an Individual Psychotherapy Session:

First you are required to read the items below so you can understand how my practice works.
Please click here to download.  (Go green, don’t print out.)

We have separated the client information form, patient request for confidential communications and signature lines from the information above, in the name of being green.

Please click here to download and print the signature pages.  Please be sure to bring the completed signature pages to your first appointment.

Forms for a Couple’s Psychotherapy Session:

Please click here to go to the Welcome page for Couples.