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Releases, Notices & Documents


Limits to Confidentiality (New Client)
BWC Initial Therapy Client Releases
Please click LIMITS TO CONFIDENTIALITY (New Client) button, above to sign and submit authorizations required to conduct evaluation. (Includes Telemedicine Release)
Click here to view or download a copy of our Limits to Confidentiality Release for New Clients
File Size: 42 kb
File Type: pdf
Download File

Please click BWC Initial Therapy Client Releases button, above to sign and submit authorizations required to begin treatment of workers injured in Ohio. (Includes Telemedicine Release)
Click here to view or download a copy of our BWC Initial Therapy Releases
File Size: 168 kb
File Type: pdf
Download File


Limits to Confidentiality (Existing Client)
Telemedicine Release
Please click LIMITS TO CONFIDENTIALITY (Existing Client) button, above to sign and submit authorizations required to conduct evaluation. (Includes Telemedicine Release)
Click here to view or download a copy of our Limits to Confidentiality Release for Existing Clients
File Size: 62 kb
File Type: pdf
Download File

Please click Telemedicine Release button, above to sign and submit authorization. 
​[REQUIRED to
receive telemedicince services: phone and/or virtual (video+audio)]
Click here to view or download a copy of our Electronic Service Delivery (Telemedicine) Release
File Size: 204 kb
File Type: pdf
Download File


Weinstein & Associates' Privacy Practices
File Size: 44 kb
File Type: pdf
Download File

Weinstein & Associates' Informed Consent
File Size: 124 kb
File Type: pdf
Download File


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​

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Landmark Centre
25700 Science Park Drive, Suite 200
Beachwood, Ohio 44122

P: 800.342.6111 | 216.831.1040
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  • Home
  • Telemedicine Check-In
  • Documents Library
  • Services
    • Forensic Psychology
    • Allocation of Parental Rights and Responsibilities
  • Locations
  • Clinical Staff
  • Contact
  • Employment