Log Me In       
Zur Institute, LLC, Innovative Online Resources and Continuing Education, Director Ofer Zur, Ph.D.
HomeArticles For TherapistsOnline CoursesPrivate Practice CatalogBlogs
Zur InstituteOnline CE CoursesForensic and Expert WitnessConsultations For TherapistsLive SeminarsFree ArticlesInvite Dr. Zur to PresentGeneral Public ResourcesAbout Zur InstituteSite MapContact Us
.



 

 

61 Clinical Forms & More
Basic Tools For Psychotherapists In Private Practice

Revised November/2010

  • These ready-to-use forms are a MUST for psychotherapists in private practice.

    Clinical Forms

  • Simply download them and insert your name and create your own letterhead and you are ready to go.

  • These forms include detailed Office Policies, Biographical Questionnaires, Treatment Plans, Consents, Releases, Sample bills, reports and letters, Marketing Plan and many other needed forms.

  • These Clinical Forms are available online in Word Document format. You can access them instantaneously online, copy them to your word processing program, insert your letterhead and name and you're all set.

  • Note: We do not mail hard copies or CDs. This offer is only for online downloads.

Clinical Forms Online (.doc)
Solo Practitioner: $99.00
Small Practice (2-4 Clinicians): $149.00
Small Group (5-10 Clinicians): $299.00
Larger Group-Agency (above 10 Clinicians): $499.00


Clinical Forms Online, Psychotherapist's Guide to Online Marketing for Private Practice & Private Practice Handbook Online (for individual practitioners) $199.00
(Receive instantaneously 3 downloads*):
* 61 Essential Clinical Forms (.doc)
* Psychotherapist's Guide to Online Marketing for Private Practice (PDF) (To review, click here.)
* The Complete Private Practice Handbook (PDF) (To review, click here.)

 

For more Private Practice Resources, HIPAA and Packages, click here.

This package includes the following forms, which no clinician should practice without:
Form #1: Office Policies & Informed Consent: This form must be read and signed before or at the beginning of the very first session. Practicing without this form may be an ethical violation and may put you below the standard of care.

Form #2: Biographical Questionnaire: Have your client fill out this three-page questionnaire before the first session. You need this information in your clients' clinical files.

Clinical FormsForm #5: Initial Assessment - After the first session: This simple two page form includes a mental status exam, DX or focus of treatment, and basic treatment plan. It is proof that you know what and how you treat your clients.

Form #16: Authorization to Release Information:  You should never release info before your clients sign this form (unless it is required by the law).

Form #22: Termination Summary: This basic form must be filled out and placed in the clinical file for each client that you have terminated with.

Form #42 and 43: Treatment Plan: A simple to fill out, two page form, articulating your DX impressions or focus of treatment, identifying short and long term goals, and outlining the type of intervention you intend to use.

Form #51: Professional Will: Prepare for the unexpected and unavoidable. It is unethical to practice without such a will and can cause major problems to your beloved ones and your estate.

Private Practice Forms Included (Updated 2010):

Most Essential - Initial Forms
1. Office Policies & General Information, Agreement for Psychotherapy Services or Informed Consent for Psychotherapy
2. Biographical Information - Intake Form (3 pages)
3. Biographical Information - Intake Form, (electronic version)
4. Biographical Information (1 page)
5. Initial Assessment after the First Session

Addendums to Office Policies (Form #1)
6. Social Networking and Online Search Policies
7. Dual (or Multiple) Relationships
8. Phones or Email Therapy
9. Treatment of Minors
10. Group Therapy
11. Touch in Therapy
12. Home Office
13. Bartering

Consents and Authorizations
14. Consent for Treatment of Minors & Others
15. Consent to Use Touch in Psychotherapy
16. Authorization Consenting to Release Information - pre-HIPAA
17. Authorization to Release Information - HIPAA version
18. Responsibility to Pay for Sessions
19. Consent for a Visitor to a Session
20. Permission to Record or Photograph Psychotherapy Session
21. Consent to Record or Videotape Training Session

Termination Forms and Letters
22. Termination Summary
23. Discontinuation of Therapy Letter (Premature Termination Letter)
24. Therapy is Terminated Due to Lack of Progress - Letter
25. Therapy is Terminated Due to Adverse UR Decision - Letter
26. Overdue Payment Letter

Billing
27. Sample Bill/Invoice
28. Super Bill
29. Patient's Ledger

Private Practice Management Forms
30. Intern Evaluation
31. Progress Notes (& SOAP)
32. Phone Consultation Form
33. Tax Deductible Expenses
34. Confidentiality Statement, Employees
35. Tracking Referral Source
36. Marketing Plan, Outline
37. FAX Cover Sheet
38. Email Signature, Re: Confidentiality
39. Outlines for a Letter Resigning from Managed Care Panels
40. Number of Sessions-Update
41. Tele-health Disclosure

Treatment Plans
42. Treatment Plan-Initial
43. Update - Treatment Plan

Subpoena & Forensic Related Forms
44. Responding to a Subpoena
45. No Subpoena Agreement
46. Request for Confidential Records
47. Workers' Compensation Medical-Legal Report
48. Forensic Agreement & Fee Schedule- Expert Witness
49. Affidavit of Merit
50. Directive to Protect Mental Health Information
51. Professional Will
52. Personal Injury Doctor's Lien

Clinical Related Forms
53. Obsessive/Compulsive/Drug Abuse Log
54. Suicide Check List
55. Suicide Contract
56. PTSD Check
57. Depression-DSM IV

Therapist's Self-assessment & Professional Development
58. Discover Your Vocation - Infusing Your Life with Joy
59. Therapists: Explore Your Relationships to Money and Marketing
60. Therapists' Self-assessment for Treating Different Aspects of Life
61. Therapists' Self-assessment for Clinical Skills


Share this:

Follow us on:


Click here to receive clinical updates by e-mail.


Online Courses  -  Zur Institute on YouTubeYouTube
Live Workshops  -  Forensic & Expert Witness Services -  Consultations for Therapists
Private Practice Handbook  -  HIPAA Compliance Kit  -  Clinical Forms  -  CE Info  -  Blogs
Online Catalog -  Free Articles  -  Boundaries & Dual Relationships  -  General Public Resources  -  Articles For General Public
Organizational Discounts  -  About Us  -  FAQ  -  Privacy, Disclaimer, Terms of Use, DMCA  -  ADA Policy & Grievance -  CV
Home -  Contact Us  -  Site Map



ZUR INSTITUTE, LLC
Ofer Zur, Ph.D., Director
Sonoma Medical Plaza, 181 Andrieux St. Suite 211, Sonoma, CA 95476
Phone: 707-935-0655, Fax: 707-736-7045, Email: info@zurinstitute.com
 
© 1997-2012 Zur Institute, LLC. All rights reserved. Privacy Statement, Disclaimer & Terms of Use. Last Modified: 12/30/2011
Site design/maintenance by R&D Web
This website is certified by Health On the Net Foundation. Click to verify.

This site complies to the HONcode standard for trustworthy health information. Verify here.

 

hr