(281) 686-9569 | ccaseylpclmft@gmail.com

Catherine Casey

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Client Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.

  • Personal Information
  • Policies and Procedures
  • Medical History

The Notice of Privacy Practices is for your information. You may print a copy if you wish, but I do not need for you to return this form to me. I will ask you to sign an acknowledgement that it was provided to you at your first appointment.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Release of Information

Note: To download Adobe Acrobat Reader for free, click here.

 

 

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Catherine Casey


(281) 686-9569
ccaseylpclmft@gmail.com

16300 Katy Freeway, Suite 100
Houston, TX 77094

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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

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Contact Information

16300 Katy Freeway, Suite 100
Houston, TX 77094

(281) 686-9569
ccaseylpclmft@gmail.com

A Therapist Website by Brighter Vision | Privacy Policy