Andrea von Troschke
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Forms
Here are some forms that I may ask you to print and fill out:
For our first session, please bring the intake form, which collects information relevant to therapy: ![]()
The consent form below explains therapy, my qualifications, fee, cancellation policy, confidentiality, emergency contacts. By signing it, you acknowledge and agree to my office policies.
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This form is only necessary, if you submit a super bill with a diagnosis to your health insurance. By signing the Notice of Privacy Practices (npp), you acknowledge the information and allow me to exchange clinical information with your insurance.
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Andrea von Troschke, MFT, ATR, BCPC (License MFC 45893) Marriage and Family Therapist, Art Therapist Registered, Board Certified Professional Counselor