If you're a new client, please complete the following forms and bring them to your first therapy session.
Adult Client Forms
- Client Contact Information
- complete and bring to first session
- Client Interview / Intake
- complete and bring to first session
- HIPPA
- sign last page and bring to first session
- Informed Consent and fees
- bring to first session but don't sign--to be discussed before signing
Child / Adolescent Forms
- Client Information for Minor/Child
- complete and bring to first session
- HIPPA
- sign last page and bring to first session
- Parental Waiver of records
- bring to first session but don't sign--to be discussed before signing
- Informed Consent and fees
- bring to first session but don't sign--to be discussed before signing
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
- complete and bring to first session
Note: To download Adobe Acrobat Reader for free, click here.