I am required by law to provide you with a copy of the HIPAA Notice of Privacy Practices so you can understand your rights and protections related to the use and disclosure of your identifiable health care information. This information is also included in the above packets.

You can type directly into these forms and then print and sign them. Please bring them with you to your appointment. If you have any questions regarding the forms please do not hesitate to call or bring them up when we meet.

Forms

Call for a free 15 minute consultation: 208-577-6617

Before We Meet:

Licenced Psychologist

It is helpful for you to print out and complete the required paperwork prior to our first session or your evaluation. If you have any difficulties downloading or printing out any of these forms please call me.

Michael Hillam Psy.D.

Please read carefully and complete these forms prior to your appointment. You can type directly into these forms and then print and sign the following pages. (Page 1 - Patient Information, Page 10 - Agreement / Consent Form, and pages 11-18 the Personal History Form. If you have any questions please do not hesitate to call or bring them up when we meet.