These forms are ONLY for patients / clients who have a confirmed appointment with Dr. Orloff. If you would like to schedule a session with Dr. Orloff, please complete the online intake form on the Private Sessions web page.
Patients and clients who have a confirmed appointment with Dr. Orloff are required to complete and sign an electronic online form prior to their first session. Below are links to HIPAA compliant forms for residents of California and residents who live outside of California. Please complete and electronically sign the form that applies to your residence. Once you click “Submit” at the bottom of the form, it will be automatically sent to us.
If you have any questions or problems, please contact Rhonda at firstname.lastname@example.org.
California Residents – Click Here
Residents Outside of California – Click Here