Tammy Powell, PCC, LLC
FORMS
**Please print and complete these forms, and bring them to your first appointment.**
**Please print and complete these forms, and bring them to your first appointment.**
Client Registration
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Client Rights & Responsibilities
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Consent to Treat
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Notice of Privacy Practices
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Fee Agreement
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Release of Information
(If necessary) |
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**Optional**
Adult Life History (for adult clients)
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Child Background Questionnaire (for child clients)
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- Tammy is happy to discuss personal needs and treatment options over the phone, or via email, prior to the onset of services.
- Therapy sessions typically are 50 minutes, but additional session time may be arranged for families, intake appointments, or extenuating circumstances.
- Tammy accepts several insurance plans, cash, checks or credit cards. She also can be considered an out-of-network provider. Payment is expected at time of service.