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If you're a new client, please complete the following forms and bring them to your first session.
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Client Intake Form
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Disclosure and Consent for Services
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No Secrets Policy for Couple's and Family Therapy Only
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Telemedicine Consent From
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Notice of Receipt of Privacy Practices - (For you to read and keep do not need to bring in)
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Acknowledgement of Receipt of Privacy Practice
- Teen Consent (Only for teen clients)
- Alcoholism Questionaire
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician,or any family members etc.), complete this form:
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Authorization to Release Information
Note: To download Adobe Acrobat Reader for free, click here.
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