Gordon Shippey, MA, LPC
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Thank you for choosing me as your new therapist. There are a few forms to complete before we get started.

​For New Clients Paying with Insurance

Patient_Registration_Form.docx
File Size: 16 kb
File Type: docx
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​Please complete and return this Patient Registration form to me three days before your first session. This gives me time to verify your benefits and give you clarity about your out of pocket costs. You can email your completed forms to me at gordon@gordonshippey.com. You can also fax (contact me for fax info) or paper-mail forms to me if you feel more comfortable that way. If you intend to self-pay, skip this form.

​Forms for All New Clients

treatment_agreement.doc
File Size: 39 kb
File Type: doc
Download File

client_information_form.doc
File Size: 41 kb
File Type: doc
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​Please complete and sign the two forms above. These can be brought with you to your first session.

Build Your Team

info_release.doc
File Size: 33 kb
File Type: doc
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Because mental health is interdependent with physical health, I ask for the privilege of coordinating your care with your other healthcare providers such as primary care physicians and psychiatrists. This release, while recommended, is completely voluntary.
2751 Buford Hwy NE
Suite 707 
Atlanta, GA 30324
verified by Psychology Today verified by Psychology Today Directory
Confidential voice mail: (404) 530-9057
Email: gordon@gordonshippey.com
  • Home
  • About Me
  • Blog
  • Resources
  • Location
  • Accepting Insurance
  • Forms