CLIENT CENTER

If you would like to review some of our forms, consents, and agreements prior to your visit please see the list below.
You will need Adobe Reader or similar application to view these PDF documents.

NEW PATIENT FORMS

Download these three (3) forms below…

• Client Information Form
• Electronic Payment Authorization Form
• PhoenixRISE Electronic Communication Policy Agreement

AND choose a provider form below to complete (4 total documents): 

• Disclosure, Consent, Financial Agreement – Dr. Burgamy
• Disclosure, Consent, Financial Agreement – Dr. Bock
• Disclosure, Consent, Financial Agreement – Stephanie Peetz, M.A., LPC

Return all 4 completed documents to our office on your first visit.

Please also review our HIPPA Privacy Policy concerning your rights to privacy and information below.

• HIPAA Form Department of Health and Human Services, Office for Civil Rights

OTHER HELPFUL RESOURCES

Colorado Psychological Association

American Psychological Association

The Center on Colfax

Colorado Department of Regulatory Agencies

10 factors to consider when searching for a gender-competent therapist for your child

Creating Safe and Welcoming Schools

Gender Spectrum

Pronoun Fact Sheet