Michael Binks, M.Ed, LPC, CADC3
Michael Binks LPC CADC 3
6903 SE Woodstock Blvd
Portland, OR 97206
ph: 503.740.0573
binks
Forms to print, review, complete, and bring to your first session...
Completing this paperwork beforehand will allow us to do business efficiently when we first meet. Rather than wading through a lot of paperwork together, we'll be able to move quickly into the more therapeutic part of our initial session.
Always feel free to wait until you can ask me questions before you sign any forms.
Please do not e-mail the completed forms. Your confidentiality is essential, and e-mail is not secure enough for the information you'll be providing.
I look forward to meeting you!
Link to "Client Information" Form (print, complete, and bring all pages)
Link to "Medical History Questionnaire" (print, complete, and bring all pages)
Link to "Client Rights" Form (print, sign, and bring)
Link to "Informed Consent to Treatment Agreement" (print, sign, and bring all pages)
Link to "Notice of Privacy Practices" (print, sign, and bring all pages)
Link to "Professional Disclosure Statement (for reading only...no need to print)
Questions about the forms?
Feel free to e-mail or call me with any questions or concerns you may have about the forms.
phone (503) 740-0573
A note on the amount & "legal tone" of forms...
All of the necessary procedural and legal details outlined in your paperwork will likely not match your picture of how therapy should sound or feel.
The idea of sharing personal details about your life to someone you don’t know can already be an intimidating prospect, and then you’re hit with pages of information and questions! I assume that you will be left feeling a bit overwhelmed.
For this reason, I think it’s essential that you take the time you need to digest the information and get your questions answered. The goal of my candor and attention to the details is that if you decide to work with me as your therapist, your consent will be as informed as I can make it.
I encourage you -at any time - to ask questions you may have about therapy (including questions about my professional background, techniques I use, suggestions I may make, consultation with other professionals, what you can expect to happen in your sessions, and the forms you complete).
Thanks for your patience with this necessary paperwork.
Think.Feel.Act.Bond.Be.
Copyright 2009, ODYSSEY Counseling and Therapy LLC, all rights reserved.
Counseling - Therapy - Coaching
Michael Binks LPC CADC 3
6903 SE Woodstock Blvd
Portland, OR 97206
ph: 503.740.0573
binks