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Barry F. Moss, Ph.D., Licensed Clinical Psychologist

Welcome,

This page is designed to provide new clients with the 6 forms needed for your first visit to my office. The forms provided are:

Client Information Form
Symptom Checklist
Issue Identification & Treatment Objectives Form
Confidentiality Form
Policy Form
Washington Notice Form

Download buttons are provided below for each of these 6 forms. The first 3 forms can be completed here online. Page links are also provided in the menu for office address, directions, viewing forms, a satisfaction survey for current or former clients, and resumé.

If you have any questions, please call or email me. My office hours are 12pm to 9pm Monday thru Thursday, and 12pm to 5pm on Friday. The best time to reach me in person is about 5 minutes to the hour 425 778-4174. You can also email me at Drbfmoss@ix.netcom.com.

Form 1: Client Informaton

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Form 2: Symptom Checklist

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Form 3: Issue Identification & Treatment Objectives Form

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Form 4: Confidentiality Form

Please download, read, and sign

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Please download, read, and sign

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Form 6: Washington Notice Form

No signature required