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:
If you have recently visited our office, please complete our Client Satisfaction Survey:
If you are a provider's office referring a client use this form:
Note: To download Adobe Acrobat Reader for free, click here .