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Suzanne Schimmel Clinical Psychologist
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About
Credentials
Types of Therapy
Resumé
Specialties
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Athletes
Young Adults
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Parents of Athletes
My Practice
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Telehealth
Contact
Suzanne Schimmel Clinical Psychologist
Home
About
Credentials
Types of Therapy
Resumé
Specialties
Areas of Expertise
Athletes
Young Adults
Addictions
Parents of Athletes
My Practice
Fees
Forms
Directions
Telehealth
Contact
Home
Folder: About
Back
Credentials
Types of Therapy
Resumé
Folder: Specialties
Back
Areas of Expertise
Athletes
Young Adults
Addictions
Parents of Athletes
Folder: My Practice
Back
Fees
Forms
Directions
Telehealth
Contact

Intake Forms

  • Mandatory Disclosure Statement

  • Notice of Privacy Practices (HIPAA)

  • Individual Intake Form and Confidentiality Preferences

  • Electronic Communication Form

  • Payment and Credit Card Authorization

Other Forms

  • Consent for Telehealth

  • Consent for “Walk and Talk” Meeting

  • Consent for EMDR

  • Release of Information Form

  • Medicare/Medicaid Opt Out Form (for anyone over 65)

  • Good Faith Estimate Form

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Telehealth Licensed States

Suzanne B. Schimmel, Ph.D., P.C.

8158 E. 5th Avenue | Suite 270 | Denver, CO | 80230

office: 303-399-0945

Email

Directions

In case of emergency do not leave a message on my office line.

Click here for a list of places to call in case of emergency.

 © 2024 Suzanne B. Schimmel, Ph.D., P.C. All rights reserved.

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Disclaimer of Liability and Privacy Policy

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