{"id":1126,"date":"2018-06-05T23:00:32","date_gmt":"2018-06-05T23:00:32","guid":{"rendered":"http:\/\/samaritanps.org\/sandbox-6-30-2018\/?page_id=1126"},"modified":"2021-04-23T02:48:20","modified_gmt":"2021-04-23T02:48:20","slug":"optional-forms","status":"publish","type":"page","link":"https:\/\/samaritanps.org\/sandbox-6-30-2018\/therapy\/optional-forms\/","title":{"rendered":"Optional Forms"},"content":{"rendered":"

Here are other forms Samaritan or your therapist may ask you to fill out.
\nTo download the therapist’s standard intake forms, including their disclosure statement, visit Find a Therapist<\/a> and click on the therapist’s name. Their standard forms are found on their profile page.<\/p>\n

Samaritan Standard Forms and Information<\/h3>\n

This is our standard packet of information, including the forms required for any new client. Download the packet for the type of therapist you’re visiting before your first appointment. If you don’t know the correct set of forms to use, the correct forms for each therapist, along with their unique and required Disclosure Form, are available on the therapist’s profile page, found from the list on the Find a Therapist<\/a> page.<\/p>\n

Masters Level forms and information<\/a><\/strong>
\nThis is the most commonly used set of forms for our therapists.<\/p>\n

Psychologist Level forms and information<\/a><\/strong>
\nFor any therapist with a psychology degree, most commonly indicated by a “Psy.D.” suffix after their name.<\/h4>\n

Low-Fee Clinic, Extern forms and information<\/a><\/strong>
\nThese forms are for externs providing therapy as part of our Low-Fee Clinic. Visit the Low-Fee Clinic<\/a> page for more information.<\/p>\n

Other Forms<\/h3>\n

Authorization to Exchange Information<\/strong><\/a>
\nSometimes in the course of therapy, your therapist may want to consult with your other providers, such as medical doctors, or other therapists counseling you or your family. If these circumstances arise, your therapist will discuss it with you and ask you to give your permission, using this form.<\/h4>\n

Questions to Ask Your Insurance Provider<\/a>
\n<\/strong>Here is a list of questions you might ask your health care provider in order to better understand the benefit available to you for services at Samaritan Center.<\/p>\n

Teletherapy – Complete Set of Forms<\/strong><\/a>
\nThe 4 forms in the set apply to initiating Teletherapy, or online therapy.<\/h4>\n