If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Intake Form
- Professional Disclosure Statement
Limits of Confidentiality/Therapy Cancellation Policy
- Fee Agreement
- Insurance Benefits Form
- Credit Card Authorization Form
If you would like me to bill your insurance provider, or coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), please complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.