2910 E. Madison, #211
Seattle, WA  98118

206.328.9871
Cheryl@CherylCebula.com

Forms

You will need the free Adobe Acrobat Reader to view these files. Please print and complete and sign all forms and bring with you to your first appointment.

1. Disclosure Statement
2. HIPAA Compliance Notice of Privacy Practices
3. Intake Information Form
4. Private Practice Insurance Billing Release