Andrea von Troschke
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Andrea von Troschke
LMFT, ATR, BCPC
(310) 569-0106
PsychotherapyArt@gmail.com

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11911 San Vicente Blvd., #280
Los Angeles - Brentwood
CA 90049
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Click below for specialties
Anxiety/Panic/Depression
Couples Therapy/Relationship Issues
Grief and Loss

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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:
intake_.pdf
File Size: 65 kb
File Type: pdf
Download File

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.
informed_consent.pdf
File Size: 112 kb
File Type: pdf
Download File

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.
npp.pdf
File Size: 119 kb
File Type: pdf
Download File

 Andrea von Troschke, MFT, ATR, BCPC (License  MFC 45893)  Marriage and Family Therapist, Art Therapist Registered, Board Certified Professional Counselor
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