Documents for Your First Appointment

In advance of your first appointment, you will receive an invitation to complete first session documents via my secure client portal SimplePractice.  

1. New Patient Intake Form

2. New Patient Medical History Checklist

3. Client Self Assessment

4. Policy regarding Email, Phone, or Text Communication

5. HIPAA Privacy Disclosure Acknowledgement

6. Treatment and Fee Agreement

HIPAA Privacy Policies:
7. HIPAA Privacy Disclosure

Insurance Information

Dr. Davis is not an in-network provider for any insurance plans.  If your insurance has an out of network benefit, clients will be expected to pay at the time of service and will be provided with a receipt that they can submit to their insurance plan.  It’s always best to call your insurance 800 number to see what your plan will cover if this is critical to your decision making.  In accordance with the No Surprises Act, as of January 1, 2022, I will provide notice of expected out of pocket expenses as required.  

Rights and Protections against Surprise Medical Bills

Checks, cash, credit cards, Venmo accepted.

 

Quincy and Rosie, the Therapy Dogs

  • Quincy
  • Rosie

Quincy and Rosie are hypoallergenic Australian Labradoodles and are Certified Therapy Dogs via the organization Dog B.O.N.E.S

They are both available for all counseling sessions if you would like them to be ther

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