Questions? Give me a call:
(925) 325-5022
for a free 15 minute phone consultation with Dr. Marc

E-mail or call Dr. Marc at (925) 325-5022 for a 15 minute free phone consultation to see if EBFT is the right fit for you and your family.

"What seems to us as bitter trials are often
blessings in disguise."
- Oscar Wilde

Forms

Below are the links to the various forms needed at East Bay Family Therapy. Our first session will have more time for discussing issues if the forms are filled out. Each adult will need to fill out and sign the Biographical Information form, and sign the HIPAA Privacy Policies Signature page and the consent form. For minors who are seeing me individually, a legal guardian must sign for them. The Release of Information is only needed if you wish for me to speak with someone else about your care.

Form Name Date Published Download
Biographical Information 02.02.2009 Download
HIPAA Privacy Policies Signature 05.02.2009 Download
HIPAA Privacy Policies 02.02.2009 Download
Informed Consent 05.02.2009 Download
Release of Infomation 02.02.2009 Download
Child Therapy Contract 05.02.2009 Download
Insurance Form 12.06.2010 Download
Payment Authorization 05.02.2009 Download