Email - info@drkerley.com
Skype ID - dckerley
Second Life Avatar - Craig Kamenev
Second Life Group - Positive Mental Health
Second Life Location - Kkotsam 169, 182
D. Craig Kerley, Psy.D.
Georgia Licensed Psychologist
Please print and complete the following forms, and email (info@drkerley.com),
mail, or fax (678-623-8234) them to me prior to our first session.
New Patient Information – This is a general patient information form.*  
Consent Forms Packet – This packet contains the following:

    General Policies and Procedures
    Informed Consent Form
    Notice of Privacy Practices
    Consent to Use and Disclose Health Information Form
    Authorization of Release Form**  

    **The Authorization of Release Form only needs to be completed if there is someone you would like for me to
    communicate with regarding our sessions [e.g., doctor, family member, school].  
Adult Intake – This file contains a background questionnaire for adults attending therapy.