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Initial Forms



If you are a new client, please complete the following forms and bring them to your first therapy session.  If you have any questions or concerns then discuss them with me prior to signing any documents.

  • Client Psychotherapy Intake Form
  • Please read the Notice of Privacy Practices and Client Rights and Responsibilities Located on this website under "Privacy and Policy", and then printout, read, and sign the Consent to Treatment  linked below.

 


 Client Psychotherapy Intake Form  
 Consent To Treatment
   

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

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website.This form is for general questions or messages to the practitioner.

Please don't put anything here:
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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website.This form is for general questions or messages to the practitioner.

Please don't put anything here:
Please enter the words below: Click to reload image What is this?


By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Helpful Forms

Click here to view and print forms for your appointment.

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