If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form (Client Intake Questionnaire)
- Nature and Risks of Therapy/ Fees/ Cancellation Policy
- Informed Consent/ Termination of Therapy
- Notice of Privacy Practices/Acknowledgement of Receipt of Notice of Privacy Practices
- Authorization for Use or Disclosure of Protected Health Information
- Telemental Health Informed Consent
- The "No SurprisesAct" Standard Notice and Consent
- Credit Card on File Policy and Authorization
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:
Note: To download Adobe Acrobat Reader for free, click here .