Helpful Forms

If you are a new client please print and complete the following forms to bring with you to your first therapy session: an office policy statement and an intake form .

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, child's classroom teacher etc.), please  print out and complete the authorization to exchange confidential information form and bring that with you as well.  We can fill it out together to include any necessary contacts.

Exchange of Information forms are limited to one year and can be renewed annually.

Child Psychotherapy Intake Form

Adult Psychotherapy Intake Form

Limits of Confidentiality/Therapy Cancellation Policy

Office Policies Form

Authorization to Disclose Information Form

Authorization to Exchange Information Form

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

Helpful Forms

Click here to view and print forms for your appointment

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