Silvina Duchini, LCSW, CCTP-II

The following forms are required prior

to the Initial Consultation

Consent for Psychotherapy

Notice of Privacy Practices

Practice Policies

Questionnaire

Telehealth Consent

Telehealth Check-In

Emergency Contact

The following forms are optional

COVID-19 Informed Consent

Good Faith Estimate

Medicaid and Medicare Opt-Out

Release of Information