If you're a new client, please complete the following forms and bring them to your first therapy session.
- Financial Agreement and Insurance Statements
- Notice of Privacy Practices
- Informed Consent
- History and Information of Patient
- Policy Statement
To complete your forms:
1.) Click on the form link above and save the PDF.
2.) Open Adobe Acrobat Reader and fill in your information. Be sure to save your changes. ( To download Adobe Acrobat Reader for free, click here )
3.) Send an e-mail to [email protected] with the filled out form attached.
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here .