Marni Millet, LCSW

Marni Millet, LCSWMarni Millet, LCSWMarni Millet, LCSW
  • Home
  • About Me
  • My Approach
  • ISTDP
  • Billing
  • Intake Forms
  • RESOURCES
  • Daily Insights
  • More
    • Home
    • About Me
    • My Approach
    • ISTDP
    • Billing
    • Intake Forms
    • RESOURCES
    • Daily Insights

Marni Millet, LCSW

Marni Millet, LCSWMarni Millet, LCSWMarni Millet, LCSW
  • Home
  • About Me
  • My Approach
  • ISTDP
  • Billing
  • Intake Forms
  • RESOURCES
  • Daily Insights

Intake Packet

Please complete the following intake form, informed consent, teletherapy policy, along with sending a Govt issued ID to my email through the Virtru app or to marnimillet@marnimillet.com

Informed Consent 2022 (pdf)Download
Intake form 2022 (pdf)Download
Good Faith Estimate Information for patients (pdf)Download
Telehealth policy (pdf)Download
HIPAA (pdf)Download
Video consent (pdf)Download
Consent for release of information (pdf)Download
Outcome Online Therapy (pdf)Download


Copyright © 2021 Marni Millet, LCSW, CASAC - All Rights Reserved


Please Email for an appointment.

Please visit my Resources Page for more helpful information.


Waiting list for ISTDP, please email for possible appointment in September, 2022. I am tele-therapy only at this time and practicing in New York and Florida.

https://flhealthsource.gov/telehealth/

You must be sitting in NY or Florida during our session, FYI, per licensure laws. Best way to contact me and receive a reply is email, as returning phone calls are not optimal at this time.

This is self-pay unless you are using Medicare or UHC/UMR

(Optum).  

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