Associated Psychologists, PLC
Please see below the following forms which may be downloaded:

1. Release of Information: to be used to give a family member access to your information as part of
treatment
, for billing purposes, or to request that information from your records be sent to another provider.
Please complete all sections of this form.


RELEASE OF INFORMATION

2. Consent for "Telehealth/Online Therapy" Services

CONSENT FOR ONLINE THERAPY SERVICES


Once completed, the form can be Faxed back to 586/776-3369.