Forms

If you're a new client, please complete the following forms and bring them to your first therapy session. We will also need a copy of your driver's license and insurance card upon your arrival to your first appointment.

• Policies and Notice of Privacy Practices
• Registration Form
• Insurance Form
• Electronic Payment Authorization
• Financial Agreement

For Parent or Guardian of Child Under age of 18 ONLY.

• Parental Consent/Agreement

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

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