Foundation for Healing, LLC utilizes Simple Practice for all paperwork & payments. Once you schedule an appointment with the therapist, we will email you a secure link for you to complete your portal information fill out intake documents, and sign electronically. It will take about 15-30 minutes to complete. If you’d like for us to communicate with another provider such as a doctor, previous therapist, support person, or another entity, please complete an Authorization for Release of Information, which is listed below, sign, date, and attach this document through the secured email address listed on this site, upload it to the patient portal, or bring with your other documents to your first session.
The Release of Information (ROI) is a valuable part of the intake process because it allows for the collection of records and information to assist with your therapy experience. You may complete as many ROI’s as needed; just be sure to follow the same protocol as stated above. Please note that the ROI is limited to the information that you have specified and authorized to be exchanged only. This document is valid for 1 year of the original date and signature or until discharged from services, whichever comes first. Therefore, ALL ROI’s must be renewed annually. Additionally, you have the right to revoke an ROI at any time with a proper signature and date, for documentation purposes.
Please also complete these additional documents below and follow the same process as with the ROI to upload them to the client portal, email, fax , or bring them to to your first session.
Email: deborahj@foundationforhealing.com
Fax: (480) 608 – 5251
Https://deborah-johansen.clientsecure.me
Authorization for Release of Information
Informed Consent for Treatment
HIPPA-Notice-Of-Privacy-Practices
Credit/Debit Card Authorization
FFH Assumption of the Risk-Liability Re-Sars-COVID-19
Please include pictures of the front and back of your insurance card along with your intake packet. Some people have found the CamScanner App. or the NOTES app. (on Apple products) to be helpful in uploading and sending documents.
