If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Intake Form
Outpatient Services Contract
- Checklist of Concerns
- Agreement for Payment
- NPP Consent 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 release of psychotherapy information:
If you would like to read how your medical information may be used or disclosed, please read the Notice of Privacy Practices. We will review the content in our first session to ensure understanding and consent.
Note: To download Adobe Acrobat Reader for free, click here.