Forms

If you are a new client, please complete the following forms and email them before your first therapy session to: [email protected].

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

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

• Authorization to Disclose Information Form

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

Without the Authorization to Disclose Information Form completed, I am unable to discuss you with anyone else, including family members.