Resources & Forms

Resources for Patients and Families

 

Anxiety Disorders Association of America

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

Johns Hopkins Outpatient Clinics



Patient Forms

Intake Form (pdf file)

Intake Form (Word document)
  • This form should be completed prior to your first evaluation.  Please fax it to Dr. Huberman at 443-957-9477.
  • This form can be used to authorize the release of information from past or current providers to Dr. Huberman.  Please try to have records sent to her prior to the initial appointment so that she has 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, Dr. Huberman 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, Dr. Huberman 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.