(760) 207-2515

dr.bgaetano@sbcglobal.net

Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Intake Form

Information Sheet

Client Release for Video Session

Limits of Confidentiality

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

Authorization For Use Or Disclosure Of Protected Health Information

Hipaa Notice Of Privacy Practices

Contact Today



To schedule an therapy appointment or to obtain additional information about any of my counseling services, please give me a call or fill out the form on this page.

Telehealth Video Sessions Only

dr.bgaetano@sbcglobal.net
(760) 207-2515

For more information on Telehealth-Video Sessions.

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