Emily Pimpinella, Psy.D.

Clinical Psychologist

Client Portal

Authorization for the Release of Confidential Information

(Use this form if you want me to share your information and/or 

records with someone else.)

Notice of Privacy Practices

Rights and Protections Against Surprise

Medical Bills for Uninsured and Out-of-Network Clients

Rights for a "Good Faith Estimate" for

Uninsured or Out-of-Network Clients