Marilyn Ross LCSW
Licensed Clinical Social Worker
Downloadable Forms
 

If you wish, you may download and fill out your client information forms prior to your first visit. If you are using insurance, please be sure to bring your insurance card to the appointment.

 

New client Information

 

Signature Page

 

HIPAA Notice

 

If you are using insurance, please fill out the following form and fax it to 512-345-2368 SEVERAL DAYS prior to your appointment so that benefits and co-pay amount can be verified.

You can find a free and secure pdf editor here (opens in browser): https://www.sejda.com/pdf-editor