BRITTANY VERA, LCSW

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  • Home
  • About
    • Meet Our Team >
      • Meet Brittany
      • Meet Jay
    • Rates & Insurance
    • Privacy Policy
    • Disclaimer
  • Services
    • Therapy Services
    • Trauma Psychotherapy
  • Resources
    • Common Questions
    • Helpful Books
    • Blog
  • Book Appointment
  • Contact

Printable Forms

Client Forms

​If you are a new client, please print and fill out these forms to the best of your ability prior to our session.  Some forms may not require a signature but contain important information about your privacy related to psychotherapy.  I will go over the forms, and any questions you may have during our first appointment.  If you are not able to print these forms, I will have them available for you in my office.  Please plan to arrive at least 15 minutes prior to our appointment to allow for enough time to complete the paperwork.
Client Intake
File Size: 481 kb
File Type: pdf
Download File

Informed Consent.pdf
File Size: 336 kb
File Type: pdf
Download File

Notice Of Privacy Practices
File Size: 836 kb
File Type: pdf
Download File

Practice Policies.pdf
File Size: 133 kb
File Type: pdf
Download File

Financial Agreement.pdf
File Size: 169 kb
File Type: pdf
Download File

Limitations To Confidentiality
File Size: 669 kb
File Type: pdf
Download File

Parental Consent Of Minor
File Size: 452 kb
File Type: pdf
Download File

Release Of Phi
File Size: 657 kb
File Type: pdf
Download File

Note: To download Adobe Acrobat Reader for free, click here.
Contact Me
Harmony Psychotherapy
501 Church Street NE
Suite 208
​Vienna, VA 22180


Phone: (703) 592-4243
Click Here To Email Me
​

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​The building is ADA accessible and contains an elevator.  If you are differently-abled and are concerned about accommodations, please let me know during the phone consultation.

Contact US

Harmony Psychotherapy
501 Church Street NE
Suite 208
​Vienna, VA 22180


Phone: (703) 592-4243
[email protected]

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Copyright © 2018. Harmony Psychotherapy LLC​. All Rights Reserved.