Lauren B. Yerkes, Psy.D.

Licensed Clinical Psychologist 

Client Forms

Client Forms

  Notice of Privacy Practices  

  Please read and review. Printing this form is optional. 

  Reciept of Notice of Privacy Practices

  Please print and complete after reviewing the Notice of Privacy Practices to bring to your first session.

  Office Policies and Procedures  

  Please print and complete to bring to your first session. 

   New Client Intake Form  

  Please print and complete to bring to your first session.

  Consent to Release of Information

  This form is necessary only if you would like to grant me permission to release confidential information to another person, provider, or agency.

  Please print and complete one form for each person/agency if you would like to grant this permission.