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Individual, Couples, and Family Counseling // Online Counselor Supervision

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

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

 


 

A PDF version for your records, if you need a copy.

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

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

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

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.

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