Home  ·  About Me  ·  Contact Me  ·  Services and Fees  ·  Site Map  ·  Shopping Cart
Download Forms
Search By Keyword

Search By Keyword


Video Calls Using:


Yahoo Messenger


Before your initial assessment, I need you to fill out the following forms.  Please print the forms and sign all of them except the client information form.  If you plan to use my online service, fax or mail the forms to me, using the contact information at the bottom of this page.  You can keep a copy of the HIPAA form and I’ll send you a copy of the disclosure after I’ve signed it.  If you plan to see me in my office, just bring the forms with you to your initial assessment. 

Client information
Disclosure
HIPAA privacy form
Financial information
Credit Card Authorization

 

 

 

Contact information: Julie Unger, LPC, NCC
                                    6638 W. Ottawa Ave, Ste. 160-2
                                    Littleton, CO 80128
                                    Phone: 720-480-1428
                                    Fax: 303-972-8081
                                    julieunger@comcast.net

 

 

 

 

 

 

Contact information: Julie Unger, LPC, NCC 6638 W. Ottawa Ave, Ste. 160-2 Littleton, CO 80128 Phone: 720-480-1428 Fax: 303-972-8081 julieunger@comcast.net