Forms

Dr. Ildiko Tabori 

If you are a new client, here are a few forms you will need for your visit.  Please bring these signed forms with you on the day of your first appointment.  If you have any questions or concerns about these forms, please do not hesitate to contact us

 

Patient Intake:

 

Patient Intake Link

 

Patient Forms:

 

Informed Consent - Therapy

Informed Consent - Evaluation

Informed Consent - Online

Financial Agreement

Fee Schedule - Acknowledgement

Special Litigation Consent

Privacy Policy - Signature

Release of Information

 

Patient Forms (Minor)

Informed Assent

Informed Consent - Therapy Minor

Informed Consent - Evaluation Minor

 

Insurance, Fees and Payments

Fee Schedule - Standard

Fee Schedule - Forensic

Credit Card Authorization

 

Privacy Policy

Privacy Policy 

 

Privacy Policy Signature

Privacy Policy Signature

 

Testimonial

John T.

"For the last two years, I have been meeting Dr. Tabori regularly. As a new resident in LA whose wife has dementia and is living in a skilled nursing facility, my life has been dominated by distress and chagrin. Dr. Tabori has not only assisted me in coping with my situation, but has made recommendations that have enhanced my sense of personal equanimity. There is no question that this has been communicated to my wife because she, too, appears to share my enhanced condition in her own life."

Read more testimonials about Dr. Tabori