Forms

All forms may be uploaded through the PsyBooks EHR platform or brought as a signed copy to an in-person session

Before your initial appointment:

Informed Consent

Intake Form

HIPAA policies (Read Only)

Miscellaneous Forms:

Good Faith Estimate Form  – For clients who are Self-Pay and Out of Network

No Surprises Act Disclosure Notice  – Read only for Self-Pay and Out of Network clients

Release of Information Form – please fill out and bring with you if you have other parties with whom you wish me to communicate to benefit your treatment (e.g. previous therapist, psychiatrist or other physician)

Continuing Care Form – For ongoing clients to update at the beginning of each calendar year

Collateral Consent Form

Medicare Eligible Patient Agreement

These are the most recent forms. If you began treatment with Dr. Hopper before January, 2025, please contact her for older versions.