Intake Information Form

Client Rights
Please review your list of rights as a client of Williamson Counseling.

HIPAA Notice
There are some instances where limited information about you may be shared with others. (i.e. insurance billing) Please review and sign the HIPAA form to acknowledge this.

Receipt of HIPAA

Informed Consent
Please review and sign this document to acknowledge you give Williamson Counseling permission to be your treatment provider. This form also has a space to include your physician’s information so that I┬ácan discuss your progress with your physician if appropriate.