N. David Hubbard, MS, MA, LMHC
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Important Forms to Complete

The following forms are required to be completed prior to your first appointment. You may simply download, review, and sign the forms at your leisure 
and bring them with you to your first appointment, or arrive at 30-45 minutes prior to your appointment to complete them. Scroll down below to download the forms.

    1. Informed Consent & Counseling Services Agreement 
    2. Patient Stress Questionnaire        
    3. Client Data Form

informed_consent_30a_therapy.pdf
File Size: 168 kb
File Type: pdf
Download File

client_data_form_30a_therapy.pdf
File Size: 177 kb
File Type: pdf
Download File

patient_stress_questionnaire.pdf
File Size: 38 kb
File Type: pdf
Download File

You'll also find at the very bottom a document that I am required to share with you about privacy because of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA requires me to keep your Health Information private and to give you this notice about my legal duties and my privacy practices. It is not necessary to print this form. I will provide you the form when we meet and/or you may also view it below.  

hipaa_notice_of_privacy_practices_july_2015.docx
File Size: 19 kb
File Type: docx
Download File

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