Dr. Mandy Menzer
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Forms for Individual Therapy
Please complete the following and bring them to your first session. 
Informed Consent/Office Policies
File Size: 168 kb
File Type: pdf
Download File

Telehealth consent form
File Size: 75 kb
File Type: pdf
Download File

COVID in person consent.doc.pdf
File Size: 235 kb
File Type: pdf
Download File

HIPPA policies
File Size: 206 kb
File Type: pdf
Download File

HIPPA acknowledgment
File Size: 109 kb
File Type: pdf
Download File

History form for individual therapy
File Size: 35 kb
File Type: doc
Download File


Forms for Couples Therapy 
Both members of the couple need to complete a copy of each form and bring them to the first session.
Informed Consent/Office Policies
File Size: 168 kb
File Type: pdf
Download File

Telehealth consent form
File Size: 75 kb
File Type: pdf
Download File

COVID in person consent
File Size: 235 kb
File Type: pdf
Download File

HIPPA policies
File Size: 206 kb
File Type: pdf
Download File

HIPPA acknowledgment
File Size: 109 kb
File Type: pdf
Download File

History Form for Couples
File Size: 31 kb
File Type: doc
Download File


Release of Information Form
Release of information
File Size: 23 kb
File Type: docx
Download File


Good Faith Estimate Information

Good faith estimate for out of network clients.doc
File Size: 42 kb
File Type: doc
Download File

Click here for more information on Good Faith Estimates
8700 Manchaca, Ste 402
Austin, TX 78748
(512) 696-1970
mandy@drmenzer.com
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