Janys Murphy PhD, LMHC, CDP - Clinical Mental Health Counselor and Supervisor
Forms
 
The registration form, disclosure form, and consent for electronic communication form are required for your first visit to my counseling office. Filling them out ahead of time will allow your treatment to begin as quickly as possible. As you go through the disclosure statement, you will need to initial on each item line provided to indicate your authorization. Please review the 24 notice for cancellation policy carefully, as well as the limits of confidentiality. Please check your insurance to see if your deductible is met for the year and to determine co-pay. All insurance co-pays are due at the time of the appointment. Please note that if your insurance requires pre-authorization you must have this set up prior to our first appointment. If you need me to call to pre-authorize then this is something that we will do together as part of the initial appointment.





An ROI (release of information) is filled out if you wish for me to have communication with anyone outside of the counseling milieu. The only exception to this are client under 13, as state law gives parents consent.




Office days are Tuesday, Wednesday and Friday by appointment only. My office is located at 120 Pear Street NE Olympia, WA.


 



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