Downloads

For your convenience, we are providing the following forms which you can download and complete before your visit

Adobe PDF Format	MS Word Format
confidential_information.pdf Confidential Information Form	confidential_information.doc Confidential Information Form
fee_agreement_and_policy.pdf Fee Agreement Policy	fee_agreement_and_policy.doc Fee Agreement Policy
disclosure Statement.pdf	disclosure Statement.doc -
HIPAA_notice.pdf HIPPA Notice	HIPAA_notice.doc HIPPA Notice
insurance_release_form.pdf Insurance Release Form	insurance_release_form.doc Insurance Release Form

New book featuring Stephen Covey, Ken Blanchard and Mary Ann Van Buskirk.

Blueprint for SuccessMary Ann Van Buskirk joins best-selling authors Stephen R. Covey and Ken Blanchard in a new book on success!

Mary Ann Van Buskirk

M.A., M.Div., LPC, LMFT

Certified Pastoral Counselor

Relationship Expert

Adobe PDF Format