PSYCHOTHERAPY FORMS

Download & print Forms

In order to save time when you come to your appointment, you may print out and complete the registration forms ahead of time. Or, if you prefer, you can just complete the paperwork at the time that you arrive for your appointment.  

New Psychotherapy Patients

  • Notice of Privacy Practices
  • Privacy Practices Acknowledgement
  • Informed Consent for Psychotherapy
  • Social Media Policy
  • Registration
  • COVID Informed Consent

INDIVIDUAL FORMS

Registration Form

This form includes some basic information about you.

HIPAA policies

This is information about privacy policies for your records (nothing to sign).

HIPAA Acknowledgement Form

This is a document confirming that you have been given the above HIPAA policies.

Consent FOrm (for psychotherapy)

This document provides informed consent for psychotherapy.

Social Media Policy

This document provides information about my social media policy.

COVID Informed Consent form

This document provides information consent for in-person appointments.

QUESTIONS?

Feel free to call our office for more information.

Contact Dr. Laila Spina

Office ADDRESS

Eaton Square – Villa Professional Plaza
438 Hobron Lane, Suite #415
Honolulu, Hawaii 96815

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