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.
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 |
| Child Consent Form |
| Notice of Privacy Practices |
| Receipt of Privacy Practices |
| Email Authorization Form |
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.
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 |
| Adult Consent Form |
| Notice of Privacy Practices |
| Receipt of Privacy Practices |
| Email Authorization Form |
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
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.
