The future depends onwhat you do in the present
Couple Riding Bikes

Helpful Forms

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

 


Client Psychotherapy Intake Form



Limits of Confidentiality/Therapy Cancellation Policy



HIPAA Notification of Privacy




Questionnaire for Couples



Child Intake

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

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