All of my online forms are hosted by JotForm.com and are secure and HIPAA compliant. If you wish to keep any form for your records, you can simply "Download PDF" when completing the form.
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Forms for Private Practice

Please have these documents filled out before our first meeting.
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Jirvana Weekend Welcome Form

These are forms for our participants in Jirvana Workshops.
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Jirvana Weekend Informed Consent Form

These is an informed consent form for our participants in Jirvana Workshops.
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Jirvana Weekend Schedule

This is the schedule for your Jirvana Weekend.
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Jirvana Weekend Personal and Family Assessment Forms

These forms are to be completed before your Jirvana Weekend
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Weekly Group Agreement

This is a form that describes the guidelines for the Weekly Groups.
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Confidentiality Agreement for Couples/Family Therapy

This is a confidentiality agreement form for couples and families participating in couples/family therapy.
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Release of Information

Fill out this form if you are requesting a Release of Information.
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EMDR Informed Consent Form

This is an EMDR Informed Consent Form
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Pay with PayPal

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Payment via Venmo

You can find Matt Misuraca on Venmo at @Matt-Misuraca In Venmo, please go to settings & set your account to private before paying.
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Payment via Zelle

You can find Matt Misuraca on Zelle by using my phone number (760-708-8253) in the zelle app.