Helpful Forms

If you're a new client, please allow an additional fifteen minutes for your first therapy session. You will be required to fill out the following:

  • Registration Form
  • Authorization for Treatment

If treatment is for a minor the parent or guardian will be required to fill out the following:

  • Consent for the Treatment of Minors

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), you will be required to complete this form to authorize release of psychotherapy information:

  • Consent for Release of Information

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Schedule Appointment

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Helpful Forms

Click here to view and print forms for your appointment.