Forms

StephanieWebsite-2990Please complete the following forms before your initial session:
  • Disclosure: An explanation of Stephanie’s qualifications, theoretical orientation, areas of expertise, an overview of the counseling process, email and note policy, and confidentiality and code of conduct.
  • Fee Schedule: This form highlights the terms of payment for services.
Other Forms:
House Bill 4224 (89th Regular Session)

House Bill 4224 (89th Regular Session), which went into effect on Sept. 1, 2025, requires licensees, per Section 181.105 of the Health and Safety Code, to prominently post on their website instructions to enable a consumer to:

§611.008. Request by Patient or Representative

(a) On receipt of a written request from a patient to examine or copy all or part of the patient’s recorded mental health care information, a professional, as promptly as required under the circumstances but not later than the 15th day after the date of receiving the request, shall: Make the information available for examination during regular business hours and provide a copy to the patient, if requested; or Inform the patient if the information does not exist or cannot be found. (b) Unless provided for by other state law, the professional may charge a reasonable fee for retrieving or copying mental health care information and is not required to permit examination or copying until the fee is paid unless there is a medical emergency. (c) A professional may not charge a fee for copying mental health care information under Subsection (b) to the extent the fee is prohibited under Subchapter M, Chapter 161.

How To Make A Proper Records Request

Please note that according to TX law (see above) the facility/counselor from whom you are requesting records has 15 calendar days from the receipt of your request to comply.