Public Accessed Forms
You may choose to “PRINT & SAVE” the forms as you complete them (there will be a button on each form); you may also skip the save and go instead to print. When the PRINT & SAVE dialogue box opens you can choose to save the file after you complete the forms, or you can hit “cancel” when prompted to save (choose “Cancel” if you DO NOT WANT TO SAVE the form for privacy reasons) and the Print dialogue box will automatically open.
Credit Card Authorization Form
All other forms need to be completed in a HIPAA Compliant Secure Client web portal, which the practice of LaRose uses. The secure area ensures confidentiality and all forms remain in the secure server (with nothing to print, nothing to save, nothing to carry).
What is encryption in mental health? Take a look here for a summary to ease your mind a bit and to help you be informed as you move about the web!
USERS ARE ENCOURAGE TO ACCESS OUR ONLINE SECURE AREA INSTEAD OF USING PUBLIC USE FORMS
I understand that at times other people may need some of the forms from the practice and that they do not wish to log in to use them (parents, friends, relatives) in helping to pay for services or in sending something for records. In that case the two most commonly requested forms (that could be considered more of a public use form) are listed here on this page (above). If you are a client of the practice or a prospective client you should not use THIS public use forms section in the public talkifuwant.com domain; instead please use the secure server (the client portal). In the portal you’ll be able to digitally complete all forms securely:
Returning Users Login Here
and
New Users Login Here.
All health information, demographics, family information, insurance, billing information, secure and encrypted email messages and even an optional 24 hours a day journal sharing feature are all stored and accessed securely.
And a bit of the “legal” stuff,: Our Social Media Policy | Our Private Practice Privacy Statement | Our Summary of Patient Bill of Rights Information |
A FEW LEGAL DISCLAIMERS IF USING PUBLIC ACCESS FORMS (OUTSIDE OF THE SECURE SERVER):
If you prefer to use the adobe PDF forms found on this page (and not register as noted above), online users here are encouraged to open a new tab in Internet Explorer 8 (or later) and choose the “InPrivate” browsing feature BEFORE USING ANY OF THESE PDF FORMS. After you have opened a new tab, and after you have selected “InPrivate” browsing, copy and paste the URL from this web page into the “InPrivate” browser. You will return to this page (and the URL will show “INPRIVATE”). For more information about “InPrivate” browsing users may also want to read the “Learn more about tabs and tab shortcuts, Accelerators, and InPrivate Browsing” link that will appear on the bottom of the new “InPrivate” window.
USERS WHO UTILIZE THESE ONLINE FORMS ASSUME ALL RISKS IN DOING SO, SIMPLY BECAUSE CONFIDENTIALITY CANNOT BE ENSURED BY LAROSE. USERS WHO SAVE COMPLETED FORMS ONTO A COMPUTER SHOULD KNOW THAT BY SAVING THE FILE TO A COMPUTER, YOU ASSUME ALL RESPONSIBILITY FOR THE INFORMATION YOU HAVE ENTERED ONTO THE FORM.
Users who are not comfortable with completing online forms and users who do not fully understand what information is accessible by others on the web (even for forms that are not saved or submitted) may feel more comfortable by opening and printing the appropriate form; by opening and printing the form, you will have a hard copy form that you can complete by hand. After you print and complete the form by hand, you can then mail or hand deliver the form yourself.
All “FORMS” users should download the latest version of Adobe’s free Acrobat Reader® to view, read, print, save, or otherwise access the forms that are available here. When the selected form opens, please check the “highlight required fields” box (which will appear in the top right hand side of your screen).
You may choose to “PRINT & SAVE” the forms as you complete them (there will be a button on each form); you may also skip the save and go instead to print. When the PRINT & SAVE dialogue box opens you can choose to save the file after you complete the forms, or you can hit “cancel” when prompted to save (choose “Cancel” if you DO NOT WANT TO SAVE the form for privacy reasons) and the Print dialogue box will automatically open.
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Rev. 6/6/19