DONNA MCCANN PSYCHOTHERAPIST
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Helpful Forms

If you're a first-time client, please review and complete the following forms, bring them to your first session.
  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form


If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:
  • Consent to Release Information Form

Confidentiality and Privacy Policy

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Exceptions include:
  • Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
  • If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
  • If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.​
  • Home
  • About Me
  • Appointment Request
  • Rates & Insurance
  • Forms & Privacy Policy
  • Contact Me
  • Common Questions
  • Hot Topics