Forms

Please print out these (pdf.) forms and complete them.

1. Client Information Sheet (pdf)
   
   
2. Brief Health History (pdf)
   
   
3. Informed Consent to Telehealth (pdf)
   
   
4. Release of Information (pdf) 4 copies

The forms will need to be faxed (651-925-0302 or emailed to (Kate at Kate at KateCavett.com).

You will need a Release of Information form for the emergency contact, and for collateral contacts. You and Kate will determine appropriate collateral contacts during the assessment.

We are prohibited by law from talking to anyone about you without your signed consent—a Release of Information.