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  • Home
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  • Media
    • TV
    • Podcasts
    • Topics
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  • Contact
  • Shop
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  • Home
  • About Me
  • Practice
    • Psychotherapy
    • Relationship Counseling
    • Forms / Policies
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Forms / Policies

Please complete the following forms and bring to our first sesison.
  • Biographical Data Intake Form – Dr. Mandel
  • Office Policies – Dr. Mandel
  • Telehealth Disclosure and Consent – Dr. Mandel
  • HIPAA Notice – Dr. Mandel
  • Surprise Billing Protection Information – Dr. Mandel
  • Good Faith Estimate Notice – Dr. Mandel
  • Signature Page – Acknowlegement of Receipt
  • Collateral Therapy Consent – Dr. Mandel
  • Authorization to Release Information – Dr. Mandel

Psychologist, Author, and TV/ Radio Personality

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  • 818.335.6309
  • CA License #: PSY 11225
  • CO License #: PSY.0004616 (inactive)
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© Copyright Dr. Debra Mandel – All rights reserved.
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