Forms and Payment Options

1. Informed Consent for Online Therapy with Dr. Howard Gurr

2. Consent for Virtual Reality Therapy

Virtual Reality Exposure Therapy is extremely safe for the general population. A small percentage of the population may experience motion sickness (nausea, vomiting, ataxia, disorientation, eye strain and vertigo) due to “sensory cue incongruity”. That is due to differences between what they are perceiving in the virtual environment being different from what their body is experiencing. However, it should be noted that improvements in the lag time between the virtual images and head movements have reduced these side effects for many people.

There are some issues and disorders that are contraindicated for this type of procedure (see below for contraindications). Please read through the list of medical conditions on the CONSENT FORM. If you have been diagnosed with or believe you suffer from any of the listed medical conditions, mark the condition and notify Dr. Gurr.

3. Patient Intake Questionnaire

4. Consent for Release of Confidential Information

Make payment for Therapy session here:

Payment for Intake Session $250.00:

Payment for Therapy Sessions $225.00:

Payment for Consultation $200.00:

Payments through Paypal for other amounts: