If you are a new client, please complete the following forms

and bring them to your first therapy session.

Client Psychotherapy Intake Form

Limits of Confidentiality/Therapy Cancellation Policy 

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:

Authorization to Disclose Information Form

HIPPA Form   (please read the entire form, but you only need to print and sign the last page)

Note: To download Adobe Acrobat Reader for free, click here.