Debra A Weaver Phd
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Forms

Licensed Clinical Psychologist

Please fill out the appropriate forms and return to Dr. Weaver via email prior to your first appointment: dweaver.phd@gmail.com

Depression, Bipolar Disorders

For those seeking psychotherapy services:

Patient Form

Consent for Psychotherapy Form

Financial Form

Notice of Privacy Rights (HIPAA) (return only acknowledgement form)

HIPAA Acknowledgement Form

Click to Download Form

For those participating in a Parenting Evaluations:

Custody Evaluation Face Sheet

Information Regarding Evaluations involving Custody, Parenting, and Visitation Issues (signature pages only)

Request Appointment
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