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Open 9 AM - 9 PM Sun-Sat
103 Old Court Rd. Baltimore, MD 21208

Policies & Forms

Confidentiality & Privacy Policy

A therapist is legally prohibited from disclosing any information about a client without that client’s explicit permission.  The only exceptions are the therapist believes that the client is a danger to him/herself or to others, or if the therapist has a reasonable suspicion of abuse of a child under 18 years old or a vulnerable adult.

Please see the full notice of privacy practices here.

Forms

If you’re a new client, you will need to fill out and sign the following forms.  Please do not fill them out until you have been instructed to do so. You can fill them out in any of the following ways:

  1. Download them here, fill them out, and bring them to the office
  2. Download them, fill them out (digitally or by hand), scan, and send them back to info@baltimoretherapycenter.com.
    Please note that e-mail is not a perfectly confidential means of communication. There is a chance that these files could be exposed to unknown third parties on the Internet. They may also be exposed to people in your home or, if you are using your work e-mail, your employer. Please take these facts into consideration before choosing this option. See Consent to Treatment form for more information.
  3. Fill them out by hand in the office.

To read before signing:

Consent to Treatment

Notice of Privacy Practices

To fill out and sign:

Client intake form

Cancellation Policy


The following forms do not need to be filled out unless you are specifically asked to do so by your therapist:

In order for me to communicate with other relevant parties (for example, your psychiatrist, primary care physician, school guidance counselor, etc.), I will need you to complete and sign this form to authorize me to release your/your child’s information:

 

Note: To download Adobe Acrobat Reader for free, click here.

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Our Blog

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September 4 The Risks of Picky Eating (How Bad Is It Really?)

Have you seen this alarming article yet? ‘Picky’ teen goes blind after diet of only fries and chips, study says. Apparently a British teenager refused to eat anything but “french fries, Pringles, white bread, processed ham slices, and sausage” and the lack of proper nutrients actually caused him to go blind. So this is probably […]


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August 14 Why Don’t My Adult Children Want to Talk to Each Other?

The past couple of posts have been addressing parents of adult children and discussing the family conflicts that are not uncommon in such relationships. Continuing on the theme, I’d like to touch on the issue of strained relationships between adult siblings. This is often a cause of great pain for older parents who feel their […]


By Raffi Bilek
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July 22 Why Don’t My Adult Children Want to Talk to Me?

In our last post I offered some ideas on how parents can go about reconnecting with adult children who have become distant and disconnected. In this post I’d like to talk a bit more about what is often behind that distance. Why have your kids decided to distance themselves? Obviously, there are many possible answers […]


By Raffi Bilek
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Our Testimonials

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Raffi led an informal group which I attended along with a few classmates from Israel in the summer of 2010. We had just returned to New Jersey from studying in a one- to two-year fellowship abroad. Ra

Chanan Siris
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Highly professional but down to earth. Both my husband and I felt completely understood and valued; something couple’s often fear simply cannot be achieved. I’m sure we’ll return we need a “tu

TA
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Raffi made me enjoy going to therapy. I have learned to talk through issues that seemed impossible and I feel so much better about the communication in my relation

Tyson V.
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My boyfriend and I see Raffi and it was the best decision we ever made. It is hard to gather the right words to describe him and how much he has helped us and our

Summer H.
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Caitlin is so special. She is an excellent listener and offers valuable and practical advice for improving life circumstances. I would highly recommend her to anyone looking to grow and improve their

Devorah Mattes