NOTE: For teletherapy services, you will need to authorize Dr. Kelly to contact at least one emergency contact person who is nearby you in case an emergency situation arises during your session. Please feel free to ask about this or any other issue related to these forms.
We welcome your questions and Dr. Kelly encourages you to have all questions answered to your satisfaction prior to signing these agreements..
Treatment Agreement/Informed Consent Form
Notice and Acknowledgment of Privacy Practices
Authorization to Share Information
Informed Consent for Teletherapy
Notice of Possible Service Disruption related to -19
Note: To download Adobe Acrobat Reader for free, click here .
From 405 or 5 Freeways: Take 133 South (Laguna Freeway) towards Laguna Beach. As you approach the Festival of Arts/Laguna Playhouse grounds on your right, stay to the left and turn left at the light at Forest Ave. Pass Ocean Ave. and turn right at the stop sign in front of the Fire Dept. Continue through two stop signs. Turn left at the next stop sign, Glenneyre St. The 380 Glenneyre Building is just past Mermaid St. on your left (see driveway into parking area in the middle of the block) before you reach the next stop sign at Park Avenue. Turn left into the breezeway and the parking lot of the building.
From North of Laguna on Pacific Coast Highway: Take PCH south past Laguna Main Beach (basketball courts and beach on right, two gas stations on left.) Proceed to the fourth set of traffic lights, at Legion St. Turn left on Legion St. At the first stop sign, Glenneyre St., turn left. Follow Glenneyre St. past the 4-way stop sign at Park Ave. and Glenneyre St. Turn right in the middle of the block into the breezeway and the parking lot of the 380 Glenneyre Building.
The building has a small customer parking lot shared by several businesses. You may take an open slot if the sign says "The Psychology Center" (far left side) or "Health in Balance" (under the carport.)
IMPORTANT: Please allow ample time for parking as you may not find an open space in the lot and may need to look for metered parking on an adjacent street. There is a metered parking lot at the corner of Glenneyre and Mermaid Sts. and a 2-story brick metered parking structure one block up on Glenneyre St. as you go up the hill, - just south past the 4-way " Stop." at Park Ave. & Glenneyre St.
Suite G is located on the second floor at the rear of the building. The easiest access is through the metal gate at the right rear of the parking lot and up the steps. Entrance is then on your right through the "G" door.