KATHERINE WARD, LCSW


*PLEASE PRINT AND COMPLETE THESE FORMS; YOU CAN SCAN AND EMAIL THEM BACK

      TO ME OR BRING THEM TO YOUR NEXT SESSION.

*YOU ONLY NEED TO COMPLETE THE FINAL FORM IF YOU ARE USING INSURANCE TO

      HELP COVER SESSIONS WITH ME.

*PLEASE KEEP THE DISCLOSURE STATEMENT AND NOTICE OF PRIVACY PRACTICES

     FOR YOUR RECORDS; YOU ONLY NEED TO SEND ME THE FORMS THAT ACKNOWLEDGE

     THEIR RECEIPT. THANK YOU!