Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Intake Form

Client Intake Questionnaire

Authorization to Disclose Protected Information

Information Sheet

Limits of Confidentiality

Confidentiality And Cancellation Policy

Consent For Treatment-Registration

Insurance Verification

Psychotherapy Checklist

Psychotherapy Intake Form

Psychotherapist-Patient Services Agreement

Acknowledgement HIPAA Privacy Notice

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

Teletherapy Informed Consent