Forms & HIPAA

Please access your Client Portal to complete all paperwork online. If you are a new client and have not received the invitation to activate your Client Portal, contact Sunrise Psychology via email or phone to have the link sent to you again.

Current Clients: Access your Client Portal through the following link:

Client Portal 

If you are unable to complete the paperwork electronically, you can view, print, and complete the following forms. Please contact Sunrise Psychology about how to return them prior to your first appointment. 

Client Information Form

Disclosure & Consent Form

Consent Form for Teletherapy

Financial Form & Credit Card Authorization

Insurance Release of Information

General Release of Information – (if needed)

Adolescent Release of Information for Parents – (needed for clients 13-17 years old)

Please download and review the following forms prior to your first appointment:

HIPAA Notice of Privacy Practices Special Confidentiality Notice for Parents

Privacy

I want you to know that I will treat the information you tell me with great care. My professional ethics (my profession’s rules about moral matters) and the laws of Washington State prevent me from telling anyone else what you tell me unless you give me written permission to do so. These rules and laws are the ways our society recognizes and supports the privacy of what we talk about—in other words, the “confidentiality” of therapy. However, I cannot promise that everything you tell me will never be revealed to someone else. There are some times when the law requires me to tell things to others and there will be limits to our confidentiality. I encourage you to read over the Disclosure Statement prior to your first appointment and invite you to ask any questions you may have. Prior to beginning any services we will go over any questions you have and both of us will sign a form stating that you have read and understand the limits of our confidentiality. I want you to feel safe and respected; I take great pride in maintaining the confidentiality of my clients and if for any of the required reasons it needs to be broken I will tell you.