If you're a new client, please complete the following forms and bring them to your first therapy session.
- Disclosure Statement
- Patient Intake Form
- HIPPA Form
Client and Counselor Responsibilities and Rights
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:
- Authorization to Disclose Information Form
Note: To download Adobe Acrobat Reader for free, click here.
|Patient Intake Form|