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.