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Helpful Forms

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

  • Client Information Brochure
  • Client Information Questionnaire
  • Notice of Privacy Practices
  • Consent to Use & Disclose Protected Health Information (PHI)

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
Client Information Brochure
Client Information Questionnaire
Notice of Privacy Practices
Consent to Use & Disclose PHI
Authorization to Disclose Information Form

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