Jen McVann, MS LMFT CST
Individual, relationship, and sex therapy
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Forms

Before you arrive, please fill out the following forms.  Feel free to either fax the forms to me ahead of time or simply bring the completed forms to the first session, whichever is more convenient.  If you are coming to therapy with a partner, each partner should fill out his or her own forms.

Forms to fill out: Forms for your reference:
Billing & Insurance Information
Therapy Policies Agreement
Client History
Patient Health Questionnaire
Telehealth Informed Consent
HIPAA Notice of Privacy Practices
Client Bill of Rights

If you have another therapist, psychiatrist, or primary care physician with whom you would like me to coordinate your care, please also fill out the following:

Authorization to Release Confidential Information

 

Make an Appointment
Jen McVann Therapy, LLC
6800 France Ave. S. Suite 560
Edina, MN 55435
(612) 524-8008
therapy@jenmcvann.com