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Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

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

If you represent an agency and would like a form to refer a client to us:

  • Referral Form for Agency Use
Client Psychotherapy Intake Form  
Limits of Confidentiality/Therapy Cancellation Policy  
Authorization to Disclose Information Form  

  Referral Form for Agency Use
 
Drug Test Schedule
 



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Helpful Forms

Click here to view and print forms for your appointment.

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