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Free 15 minute consultation to determine next steps
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HIPAA Privacy Notice

I have reviewed the Privacy Policy:*

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Client rights and responsibilities are important to us at Beyond Broccoli™. Please review our HIPAA and PHI privacy agreement here. Copies of these forms are found in your initial intake packet, signed and dated by clients and clinicians.

Questions/Concerns?

For your protection and confidentiality, do not enter personal information pertaining to your mental health condition on this form. Include your phone number and the best time to get in touch with you, and your request will be answered in 1-2 business days.

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HIPAA Privacy Notice

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