
FISHER BEHAVIOR
SCIENCE-BASED MENTAL WELLNESS
Dr. Lorrie Fisher PhD, MFT, BCN, NBCFCH
Accelerated Online Therapies
310.703.7449 call/text
lorrie@fisherbehavior.com
FILLABLE FORMS
Forms can be annoying, but they help us to help you.
Please fill and submit all of the relevant forms
at least 24 hours prior to your first appointment.
If you have questions, please contact Dr. Fisher.
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"No Surprises" Informed Consent for ALL clients
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Telemedicine Consent for ALL clients
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Adult Intake for all adults age 18+ or emancipated teens
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Pediatric and Teen Intake for all people age 17 or younger
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Couple's Intake to initiate couple's reintegration therapy
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Substance History if there is a substance use/abuse history
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Consent to Record one for each participant for all therapy sessions
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HIPAA Privacy Release permits information sharing with family or other professionals
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QEEG (Brain Map) Instructions to help you prepare prior to a QEEG test
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Home Equipment Agreement submit prior to receiving any type of equipment on loan
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Halo Investigative Use Agreement submit prior to use of the Halo investigative device
Consult with an Orthomolecular Physician?
If you haven't done a test for genetic variants please ask us about
the impact of this information on optimal progress in your therapy.