If you're a new client, please print and read the Disclosure Statement form, then print and complete the Counseling Intake Form.
Please bring the Counseling Intake Form with you to your initial session.
- Counseling Intake Form
- Disclosure Statement and Office Policies
- HIPAA Notice of Privacy/Confidentiality
- Office Policies and Privacy
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete the form below to authorize release of psychotherapy information.
Note: To download Adobe Acrobat Reader for free, click here.