• Client Information Form

Click above to access the secure form.  All new clients are requested to complete this form before their first appointment.

• Electronic Professional Disclosure Statement

The statment will be reviewed at our first session.  You will need to sign this statement before receiving services.

• Request for Non-secure Communications

You will need to complete this form if you desire to receive communication using regular email and/or text-messaging.

• Electronic Records Disclosure Statement

This statement outlines the security methods applied regarding records and communication.

• Consent for Release of Information (ROI)

This form will need to be signed if you consent to the release/exchange of your health information.

• File/Document Upload
  

Click above if you need to send a file or document to Dr. Royal.  This is a secure form of file transmission (Please refer to Electronic Records Disclosure Statement for more information about security). You will need to login with a Google account in order to use this feature.

• HIPAA Notice of Privacy Practice

• Telehealth Disclosure Statement

This statement will need to be signed, in addition to the Electron Professional Disclosure Statement, if receiving services via telehealth.