This section of the website contains forms that you should fill out online and print after they're completed. You can bring them with you to a therapy session, fax them in advance to Dr. Mazza at 301-469-7200, or after following the directions in the last paragraph, e-mail the completed forms.
Some of the forms such as the New Client Information Form should be completed prior to our first session. You may also print out and review the Treatment Agreement form and the Confidentiality Agreement, as you will be asked to sign those at the first session after we discuss any questions you might have. The Brief Health Information form is a useful way for you to summarize your health history and is helpful to have filled out prior to our first session.
To E-mail the completed forms: The forms are easy to fill out while you are at your computer. Just move your cursor to a blank space on the form and start typing. Once everything is filled out, click on the save icon on the upper left and save it to a location on your computer you can easily find later. Then email me at firstname.lastname@example.org and attach the saved file. That's all there is to it.
to Release Protected Health Information
Health Information Form
- New Patient
for Confidential Handling of Health Information
- Treatment Agreement and Notice of Policies and Procedures to Protect the Privacy of Patient's Health Information