A) Informational Brochure: “About Therapy with Dr. Hofstetter”
(Read brochure & initial that you did so on your agreement form.)

B) Notice of Privacy Practices
(Read & initial that you did so on your agreement form.)

C) Informed Consent/Agreement Form

D) Telehealth Consent

E) Patient Information Form

F) Email / Texting Communication Agreement

G) Credit Card Authorization 

H) Authorization for Release of Information (if applicable)

I) PsyPact:  Only for patients outside of California & Arizona (if applicable)

Below is for Medicare beneficiaries only. please sign both of the forms below:

J) About Private-Pay Services Contract (Medicare Opt-Out)

K) Dr. Hofstetter’s Medicare Opt-Out Provider Contract