Forms

Please let me know if you would prefer to arrive 15 minutes early to your appointment to complete paperwork or if you would prefer to complete paperwork at home. If you complete at home, it is only necessary to print and bring the New Client Data Form and the Receipt and Acknowledgement of Privacy Practice and Informed Consent. 


Please read the Privacy Practice and Therapy Informed Consent carefully and bring any questions you have to our first session.

Stacey Uebersax, Psy.D.

314 Wyndhurst Avenue
Baltimore, Maryland 21210

Roland Park

(443) 622-6876 mobile

(443) 687-8679 fax

StaceyUebersaxPsyD@gmail.com

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