Registration Forms and Policies

I am working largely via telehealth. If we have agreed to meet in person, my office is located in the Hommati Building at 6264 S. Sunbury Road, Westerville, OH 43081.  My suite is on the lower level and the waiting room is at the bottom of the stairs immediately on your right.  ​Please return the appropriate set of registration forms to me prior to our first appointment: 
email: Allison@DrAllisonFagan.com
fax: 614-895-2137 
postal mail: 6264 S. Sunbury Road, Suite 400, Westerville OH 43081

• Registration forms for Reproductive Health Consultation (donor egg, donor sperm, donor embryo, gestational carrier).  All involved parties need to complete all forms. 

• ​Registration forms for Individual Psychotherapy

• ​​Registration forms for Couples Counseling.  Both partners need to complete all forms.

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Other helpful forms: 

• Informed Consent to meet via telepsychology and important instructions for doing so
• Informed Consent to meet in person during COVID-19
  
• Request that I keep a credit card on-file
• Release of Information so that I can communicate with another person or agency
• ​My HIPAA Privacy Policies

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