Forms:
In order to make the most of our time together during your first appointment, please fill out the "Client Contact and Insurance Information" and appropriate "Background Information" form and bring them with you for your initial consultation. If you do not have access to a printer, I will have a copy of these documents at my office and you can fill them out there (please notify me in advance and arrive 30 minutes prior to the scheduled appointment time). If you are using your insurance benefits for services, please also complete the "Financial and Insurance Policy."
(Please scroll down for additional necessary forms below)
| WPS Client Contact and Insurance Information |
| WPS Background Information Form - Child |
| WPS Background Information - Adult |
| WPS Financial and Insurance Policy |
Please also review my office policies/consent for services, as well as privacy practices, and bring these forms with you. We will discuss this information at the beginning of your first session so that we have an understanding of how we will work together.
| WPS Consent for Services |
| WPS Notice of Privacy Practices |
If you are seeking services for your child and the child's parents are divorced or in the process of divorcing, please also review and complete the policy regarding court related services.
| WPS Custody Dispute Contract |
A release of information form should also be completed to allow me to communicate with other professionals involved in your care, such as a primary care physician, psychiatrist, school, or previous mental health provider.
| WPS Release of Information |
Westlake Psychological Services, PLLC 1301 S. Capital of Texas Highway, Suite C-130 Austin, Texas 78746 512-917-1307
