This Google Form was created within Roadmap Psychotherapy's Google Workspace and is HIPAA compliant due to the Business Associate Agreement (BAA) between Google Workspace and Roadmap Psychotherapy. This information will not be shared with parties outside of Sadie Lipman and Roadmap Psychotherapy unless a formal release of information is requested.

Please note that Roadmap Psychotherapy does not provide crisis management. If you are experiencing an emergency, please call 911 or 988 (national suicide hotline). If you prefer text, you can text "Hello" to 741-741, a crisis text line.