Client Forms

Prior to our first session, I will be sending you a link via email to sign up for a patient portal. There you will be asked to fill out several forms, including:

Client Intake Form

Information Sheet

Limits of Confidentiality

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

 

Contact Today



630 B Ave, Suite 2
Lake Oswego, OR 97034

drshannonodell@outlook.com
(503) 490-2143

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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.