Helpful Forms

If you're a new patient, please complete the following forms and bring them to your first therapy session.

• Client Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
• Psychotherapy Assessment Checklist
• Psychotherapy Agreement Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information.

• Authorization to Release Information Form

 

Client Psychotherapy Intake Form

Limits of Confidentiality/Therapy Cancellation Policy

Psychotherapy Assessment Checklist

Psychotherapy Agreement Form

Authorization to Release of Information Form

In addition, you may wish to read the HIPAA Notice of Policies and Practices on the link below.

Notice of Policies and Practices

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