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Debra A Weaver PhD LLC
 
 
 
 
 
 
 
 
 
 
 

Forms

 
For those seeking psychotherapy services:

Please download and complete the following forms:

Patient Information Form
Consent for Psychotherapy Form
Financial Form
Notice of Privacy Rights (HIPPA) (you may read only or keep for your records)
HIPPA acknowledgement form

For those participating in a Parenting Evaluation:

Please download and complete the following forms:

Personal Information Form
Parenting Evaluation Provisions Form
Forensic History Questionnaire—Life History Part 1
Forensic History Questionnaire—Life History Part 2
Forensic History Questionnaire—Current Status
Parenting History Survey

If you are unable to download any form, please notify Dr. Weaver so that copies can be made available.

When you enter the waiting room, please have a seat and you will be greeted shortly. If you have any questions, please feel free to contact Dr. Weaver before you arrive.
 
 
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