Forms
Fax documents to 402-403-3759 or email a scanned copy to brianhofsommercounseling@gmail.com
Hofsommer Client Registration.docRelease of Information BH.docNew Client Intake
Bring your registration documents with insurance card to your first appointment. It must be fully completed before it is accepted, but you may wait to sign until your appointment.
(Optional) Release of Protected Health Information
This document allows me to release, share, or obtain protected health information from another person or organization. It must be fully completed and signed before it will take effect.