Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.  If you are a couple, each complete the intake form.

• Client Psychotherapy Intake Form 
• Limits of Confidentiality/Therapy Cancellation Policy 
• Privacy Practices and Privacy Statement  
• Counseling Informed Consent

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

• Authorization to Disclose Information Form 

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

SCHEDULE APPOINTMENT

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