Tele-Health Forms

Informed Consent for Tele-Health. This must be signed before we begin tele-health services. Download the pdf-it is fillable on the computer. Then either print it and bring it in to me or upload it to the client portal link above. Please do not email me confidential documents. A list of local ER’s is at the bottom of this page. You must put an emergency contact that is not you and is preferably someone local.

Tips for Videoconferencing This is an informational handout but please read it.

You can now email the forms to which is an encrypted email server.

Instructions for Tele-Health

I am using Simple Practice Tele-health which provides secure service via Zoom.  The good news is you will get an email from simple practice with a link that takes you right to me. If you are linking on a device you will have to download an app the first time.I have had no issues with this platform!


Local Emergency Rooms

Alta Bates Emergency Department
(510) 204-4444           2450 Ashby Ave (@ Colby Street)

Summit Hospital-Emergency Department
(510) 869-6600
350 Hawthorne Ave (34th & Webster)

Kaiser Oakland
Address: 275 W MacArthur Blvd, Oakland, CA 94611
Phone: (510) 752-1000