Resources & Forms

Resources
 
 

Association for Behavioral and Cognitive Therapies

Association for Conextual Behavioral Science

International OCD Foundation

The Ashton Manual on Benzodiazepine Withdrawal

ACT with Compassion

The Compassionate Mind Foundation

Self-Compassion

 
Patient Forms
 
Intake Form (pdf file)
 
Intake Form (Word document)
  • This form should be completed prior to your first evaluation.  Please fax it to Amy Huberman, MD, at 443-957-9477, if time allows.  Otherwise, please bring the completed form to your initial appointment.
  • This form can be used to authorize the release of information to me from past or current providers.  Please try to have records sent to me prior to the initial appointment, so that I have an opportunity to review them in advance.
  • This form is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA).  Please review it prior to our first appointment.  If you have any questions about the contents, I would be happy to review them with you in person.
  • This form provides you with an opportunity to give or deny consent to the release of your health information for specific purposes.  Your signature acknowledges that you have received the Notice of privacy practices (above).  Please bring a copy to your first appointment.  If you have any questions about the contents, I would be happy to review them with you in person.
  • Please review this form prior to the initial appointment.
  • Please bring the completed form to your initial appointment.
  • If you have Medicare, please bring the completed form to your initial appointment.