Ellen Dye, Ph.D - psychologist in Rockville
Dr. Dye is currently taking new clients and seeing existing clients via phone, FaceTime, Zoom, and Duo.

Forms & Links

Please send your forms to the office of Dr. Ellen Dye prior to your first appointment. You can send your forms to the office online (click on the title of the form) or download them and send them by mail. The online forms are sent to the office using a secure, encrypted, and HIPAA-compliant method.

Forms

Client Information Form Download

Electronic Communication Authorization Download

Informed Consent Form Download

Notice of Privacy Practices Client Acknowledgement Download

Telehealth Agreement Download

Credit Card Authorization Form Download

Informed Consent for Treatment

Notice of Privacy Practices

Exchange of Information Form Download

 

Links

Maryland Psychological Association

Anxiety Disorders Association of America

National Institute of Health - Depression

National Institute of Health - Bipolar Disorder