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Getting Ready for Your First Session!

Please complete and sign these

ACKNOWLEDGEMENT OF POLICIES AND NOTIFICATIONS & CONSENT TO TREAT FORM​​​​​​​S

BEFORE the first session.

Everything can be signed and submitted using your phone, computer, and/or tablet in about 5 minutes!

Introduction and Welcome!


Hello, I am excited to begin working with you! Prior to our first session you must sign and acknowledge receipt of the following policies and forms:  


  1. HIPAA Notice of Privacy Practices Form

  2. Office and Practice Policies Form 

  3. Social Media, Internet Communications, and Digital Communications Policy Form

  4. Consent to Treatment

  5. Consent to Telehealth


The following pages provide a) a brief overview of the contents and purpose of each form and b) allow you to provide your digital signature. 


By signing these acknowledgments and the consent to treatment, you are acknowledging that you have the legal authority to do so.


Full copies of each form are available for review, download, and print on the forms page of Aya Psychological and Wellness Services' website. Access them by clicking here.


If you wish, you may print out any of the forms and/or signature pages for your records. 


Click NEXT to begin.

 

Warmest Regards, 

Dr. Kenya L. King

Licensed Psychologist

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