pavel blagov, phd, licensed psychologist

Paperwork & Records

I can serve you only if you first agree to receive services from me and show that you understand their nature. Hence, to become a client, you first have to read, fill out, and sign some paperwork. Before signing anything, you will have a chance to ask me about the way I work and about my policies. (Minors or others who cannot legally give informed consent still have to understand the nature of treatment and agree to it; however, the paperwork in such cases is completed by the legal parents or guardians.)

In most cases, there are at least three pieces of confidential paperwork similar to the form you complete at any doctor's office. (a) The Background Questionnaire asks for contact information. It also has questions about your background and health. (b) The Consent Form describes my qualifications and the nature of treatment. It explains your rights, e.g., confidentiality. It also spells out my procedures and policies, including billing and fees. Signing this form means you understand and agree to the policies. You will receive a copy for your records. (c) The Receipt of Privacy Policies is a statement you sign that you received a special handout explaining federal policies that govern clinical work. I will provide that handout to you.

Psychologists are required to create and maintain confidential records. In general, the client has the right to ask to examine the records and to request amendments to them. The client also has the right to ask the psychologist to share information with a third party (e.g., a primary care provider). Third party payors, like insurance companies, may also have the right to examine the records for completeness and accuracy. If you have any concers about the creation of records, do not hesitate to discuss that with the psychologist.

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