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CLIENT PORTAL

Thank you for requesting a session, to officially book your session please complete forms and submit payment.  Your session time and date will be confirmed for you upon receipt of payment. 

We look forward to speaking with you soon, in the meantime, if this is your first session with Melissa Paramo or you haven't completed session forms please make sure to complete and submit the following client forms before your session date. 

FORMS

Client Information Form

Outpatient Psychological Services Contract

Informed Consent for Telehealth

Notice of Privacy Practices

Court and Legal Fees

Good Faith Estimate

HIPPA Information & Consent

Authorization to Exchange Confidential Information 

Release of Information Form

 

KETAMINE THERAPY

KAP Informed Consent

PAYMENT

Currently accepting Paypal, Venmo & Zelle.  Sessions available in bundles and individually at $200. 

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Melissa Paramo Logo
  • HOME
  • ABOUT
  • SERVICES
  • CONTACT
714 624-4294
Forms