Welcome to Gramercy! I’m glad you’ve chosen me to help you with your behavioral health. We can spend more time focusing on your treatment goals if you complete the New Client Package before your first session. You may complete these forms and bring them with you to your first appointment.
1. Notice of Privacy Practices: Contains HIPAA information about your privacy, protected health information (PHI), and how I will maintain your confidentiality.
2. New Client Package: Contains Gramercy’s Policies and Information, Notice of Privacy Practices Consent Form, Social Media Policy, Agreement to Pay for Professional Services, Telemental Health Consent (optional), and Client Information Forms.
3. Release of Information: Optional; complete this form if you’d like Gramercy to contact your other medical or mental health providers.
Dr. Katiah Llerena, PhD 