Required Intake Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.  There will be additional forms that will be completed during your first session.

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), are using insurance for payment of services, or wish me to speak to another person about your concerns or treatment, please complete this form to authorize release of psychotherapy information.  There is a slight fee to process information requested by attorneys, physicians, or other third parties.

Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form

 

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