Skip to content

Dawn M. Roy, LCSW

Counseling for Adults and Couples

  • Home
  • About Dawn
  • Getting Through This Time
  • Finding the Right Therapist
  • Trainings
  • Trauma
    • First Responders and Trauma
    • Guides on Dealing With Trauma
    • EMDR – Eye Movement Desensitization and Reprocessing
    • Somatic Experiencing®
  • Media
  • Forms
  • Resources

Forms

Click on any of the appropriate patient forms that you may need:

CT Teletherapy Agreement

Intake Form

Client Contact Info

Agreement To Pay

Cancellation Policy 

Office Policies

HIPPA Form

Release of Information

Confidentiality Agreement – Couples

You will need Adobe Reader to view these documents. If you need to download the Adobe Acrobat Reader click on the button below.

Share this:

  • Twitter
  • Facebook

Like this:

Like Loading...

Online Payments

Click on the logo to pay for your session or make a Co-pay

Contact Info

540 Tunxis Hill Road
Fairfield, CT 06825

Phone: 203.331.7458
Email: dawnmroylcsw@gmail.com

Fairfield Countys Finest
Featured in the Fairfield County Advocate.
Click to view my profile!

April 2021
M T W T F S S
 1234
567891011
12131415161718
19202122232425
2627282930  
     
Blog at WordPress.com.
Cancel

You must be logged in to post a comment.

Loading Comments...
Comment
    ×
    %d bloggers like this: