Sharon De Guevara MSW, LCSW - Forms and Client Information

Thanks so much for visiting Sharon DeGuevara Counseling!
Here is some information and the documents needed before our session.

Disclosure Statement, Privacy Information ( HIPPA ),
Financial Policy, Intake Form and Signature Page

After you read and print the forms, please fill out and sign them. Retain copies for your records. Please bring the completed and signed forms to your first visit.

Regarding payment, cash or personal check made payable to Sharon DeGuevara Counseling is accepted prior to our session. Another option is to pay by credit card. You may contact Sharon with questions about the fee structure and/or recommended duration of therapy sessions.

It is my intention to provide services in a professional manor consistent with accepted ethical standards of practice. Regular counseling sessions are usually held weekly and will be for approximately 50 minutes. It is impossible for any counselor to guarantee any specific results regarding your counseling goals. However, together we will work to achieve the best possible results.


pdf_iconCLIENT INFORMATION DATA SHEET


pdf_iconDISCLOSURE STATEMENT/INFORMED CONSENT


pdf_iconFINANCIAL POLICY/SIGNATURE FORM


pdf_iconHIPPA – Privacy of Information Policies


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