Laura Compian Kauffman, Ph.D.
​Licensed Psychologist
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Client Forms

The following forms can be downloaded and completed prior to your first appointment. You will need Adobe Reader to access these forms. If you do not have it installed on your computer, please click here. If you would prefer, I can also email/mail you the appropriate forms.

Child Packet Individual Forms (Under 18 Years Old)
If you are bringing your child/adolescent for treatment, you will need to review and complete ALL of the following forms prior to beginning treatment.
Child Information Form
File Size: 77 kb
File Type: pdf
Download File

Child Consent Form
File Size: 104 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 82 kb
File Type: pdf
Download File

Receipt of Privacy Practices
File Size: 52 kb
File Type: pdf
Download File

Email Authorization Form
File Size: 72 kb
File Type: pdf
Download File

Adult Packet Individual Forms
If you are an adult coming for treatment, you will need to review and complete ALL of the following forms prior to beginning treatment.
Adult Information Form
File Size: 43 kb
File Type: pdf
Download File

Adult Consent Form
File Size: 97 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 82 kb
File Type: pdf
Download File

Receipt of Privacy Practices
File Size: 52 kb
File Type: pdf
Download File

Email Authorization Form
File Size: 72 kb
File Type: pdf
Download File

 

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Laura C. Kauffman, Ph.D.
Licensed Psychologist PSY23071
650) 763-8583
drlaurakauffman at gmail.com

1220 University Dr., Suite 101
Menlo Park, CA 94025

Follow me on Twitter @ChildPsych


Content Copyright © 2009-2010. Laura C. Kauffman Ph.D. All rights reserved.
Content Copyright © 2009-2014. Laura C. Kauffman Ph.D. All rights reserved.