• 1200 5th Avenue, Suite 800 Seattle, WA 98101
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Online Forms

Consent forms, release of information forms, and information about record requests can all be accessed here

Have questions about filling out a form? Give us a call at

(206)374-0109, or complete the contact form below, and a member of our team will get back to you shortly with the support you need.

Consent Forms:

Session Recording Consent Form

Session Recording Form

eScribe Consent Form

eSCRIBE Form

Request Records:

If you are a provider, please fax a signed release of information form along with your request to (206) 374-0108. We do not accept requests via email.
If you are a client, please give us a call at (206)374-0109 to initiate a release of records. We are available 9 AM – 5 PM, Monday-Friday.

Release of Information:

Release Of Information Form

Psychotherapy Notes Release of Information:

Release Of Psychotherapy Notes Form

Get in Touch With Us

Please provide your information below and a member of our team will respond as soon as possible.

Address

1200 5th Avenue,
Suite 800 Seattle, WA 98101

Email

info@ebtseattle.com

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What happens next

  1. We review what you shared

    Within one business day, we review your responses and match you to the clinicians and programs best suited to you.

  2. We call you

    Within two to three business days, we'll call to answer questions about program structure and fees, and figure out the best next step for you.

  3. We find your next step

    Depending on availability, that may mean booking your first appointment, scheduling a consult, or adding you to our waitlist so we can reach out as soon as space opens.

Protected under HIPAA. Everything you submitted is transmitted and stored securely, and is shared only with the EBTCS clinical team involved in your care.

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