• Contact Now Schedule an Appointment

    *I am now doing telehealth sessions
    2111 Dickson Drive Suite #33 | Austin, TX 78704
    elissa.psychotherapy@gmail.com | (512) 965-9863

  • Elissa Shaw

    My WordPress Blog

    • Home
    • About
    • Services Provided
      • Cognitive Behavioral Therapy
      • Counseling for Anxiety
      • Ecotherapy
      • Mindfulness-Based Therapy
      • Self-Esteem Counseling
      • Therapy for Depression
    • Getting Started
      • FAQs
      • Rates and Insurance
      • Client Forms
      • Appointment Request
    • Resources
      • Mental Health Links
      • Physical Health Links
    • Contact
    • Blog

    Client Forms

    If you are new to the working with me, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

    Client Intake Form

    HIPPA Acknowledgement

    Credit Card Auth

    Client & Counselor Agreement

    Notice Of Privacy Practices

    Practice Policies

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

    Authorization for Release of Information

    Contact Today



    2111 Dickson Drive Suite #33 Austin, TX 78704

    (512) 965-9863 elissa.psychotherapy@gmail.com

    Contact Today

    By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

    Sanctuary Psychotherapy
    elissa.psychotherapy@gmail.com | (512) 965-9863

    A Website by Brighter Vision | Privacy Policy

    • Email
    • Facebook
    • Instagram
    • LinkedIn
    • Twitter