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
  • Telemedicine Informed Consent
  • Limits of Confidentiality/Therapy Cancellation Policy
  • Office Policies
  • 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
Telemedicine Informed Consent
Limits of Confidentiality/Therapy Cancellation Policy
Office Policies
Notice of Privacy Practices
Receipt and Acknowledgement of Notice of Privacy Practices

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

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Helpful Forms

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