Forms

In order to use our time most effectively, I ask that you read the following forms prior to our first session. You are welcome to contact me with any questions regarding these forms.

Please print and fill out the “Basic Info and Acknowledgment of Policies” and “Anxiety and Depression Assessment.” I need these forms at the start of our first appointment, so please bring them to your first appointment. You may also send them to me BEFORE your initial appointment via fax. Please also consider filling out an “Authorization to Release Information” form to give me permission to contact your internist, psychiatrist, or other current providers in order to coordinate care.

For new clients who have already talked to me and scheduled the first appointment, please login to fill out a  Biographical Information Form.

Video Sessions:

Video sessions may be offered to established patients if appropriate. If we decide to move forward in this direction with video sessions, please print and fill out the following “Telehealth Informed Consent Form”

 

 

Jennifer S. Hartman, Ph.D. is a Licensed Psychologist with the Texas State Board of Examiners of Psychologists TX License #32123). For information on how to verify a license, please click here for the Texas State Board of Examiners of Psychologists (TSBEP) websiteFor information on how to file a complaint, please click here for a PDF flyer or please click here to be directed to the complaint page on the TSBEP website.