GROWTH ACROSS THE LIFESPAN: SPECIALIZING IN CHILD, ADOLESCENT AND FAMILY WELL-BEING
Call 617-334-5753 or email our Director at jason@sequoia-therapy.com
CLIENT PORTAL
Use password for signing in -or- use the contact page to request additional forms
- FORM ONE -
INFORMED CONSENT AND ELECTRONIC COMMUNICATION POLICY FORM
Welcome to my practice. This document contains important information about Sequoia Therapy's professional services and business policies as well as clarity regarding our use of electronic modes of communication during your treatment. Please read it carefully and jot down any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agreement between us.
- FORM TWO -
AUTHORIZATION TO RELEASE INFORMATION (ROI)
The ROI is important because it empowers you to decide what information you want to released from your file, who you want it released to, as well as how long and under what statutes and guidelines it is released. The ROI protects you as well as Sequoia Therapy in that is assures that the minimum necessary HIPAA information is shared.
- FORM THREE -
NOTICE OF PRIVACY PRACTICES (HIPPA)
Sequoia Therapy understands that the information we collect about you is personal. Keeping your health information confidential & secure is one of our most important responsibilities. We need this record to provide you with quality care; and to comply with state and federal legal requirements. This notice tells you how we may use & release your health information in–and about your rights concerning the It's use and disclosure.
- FORM SIX -
SOCIAL MEDIA POLICY
This document outlines the Sequoia Therapy policies related to use of Social Media. Please read it to understand how your therapist conduct themselves on the Internet as a mental health professional and how you can expect them to respond to interactions that may occur between us on the Internet. Feel free to discuss or write us with any questions or concerns you may have.