Helpful Forms

If you're a new client, please complete the following forms at least 24 hours prior to your appointment.  Include the "Consent to Treat a Minor" for clients 18 and under.

• Client Intake
• Agency Policies and Procedures
• Consent to Treat a Minor
• Insurance Reimbursement & Therapy Policy
• Client's Rights and Responsibilities
• Billing & Insurance Information

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:

• Release of Information Form

If you have recently visited our office, please complete our Client Satisfaction Survey:

• Client Satisfaction Survey

If you are a provider's office referring a client use this form:

• Referral Form

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