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Mountains

Peace

COMES FROM WITHIN

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.

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Helpful Forms

Click here to view and print forms for your appointment.

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