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
- Notice of Privacy Practices
Receipt and Acknowledgement of Notice of Privacy Practices
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 Form
|Client Psychotherapy Intake Form|
|Limits of Confidentiality/Therapy Cancellation Policy|
|Authorization to Disclose Information Form|
|Notice of Privacy Practices|
|Receipt and Acknowledgement of Notice of Privacy Practices|
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