Forms

Helpful Forms


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

Basic Contact Information (Individual)

Basic Contact Information (Couples)

Communication Agreement For Couples

Office Policies & General Information Agreement

HIPAA Notice of Privacy Practices

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), I would need a signed release of information form from you to do so. In that case, please print out this form, complete it, and bring it in with you. (We could also handle this at a later time, as needed):

Authorization to Disclose Information Form

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



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HELPFUL FORMS

Click here to view and print forms for your appointment.

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