Welcome! I look forward to working with you.
Prior to our first session, please print each of the forms listed below. Complete them as thoroughly as you can and bring them to our first session. I will answer any questions you have about the information contained in them when we meet.
You will need a PDF reader to access the forms. If you are unable to access the forms, call me and I will mail them to you.
1. Client Information
2. Insurance Billing Form (HCFA): Complete the top half of this form. Be sure to sign in order to both release information and to permit me to bill the insurance company.
4. Agreement for treatment
5. Agreements related to Treatment
DISCLAIMER: The information on any area or page of this site is intended for information purposes only regarding an available clinical service. The diagnosis or treatment of any particular disorder by the information provided on this website, or the links referred to by this website, is not recommended, intended, nor implied. No therapeutic relationship exists between Rebecca Mueller, Psy.D. and individuals wishing to e-mail or telephone her for information or to schedule an appointment. A therapeutic relationship, if appropriate, will be agreed upon following the initial, in-inperson consultation. If a psychotherapy relationship is not possible, for whatever reason, appropriate referrals may be provided
Copyright © 2010. Rebecca Mueller, Psy.D. All Rights Reserved.