Helpful Forms

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

Client Information Form

Disclosure Agreement

Notice of Privacy Practices (HIPPA)

Acknowledgement of Receipt of Privacy Practices


For adolescents, please fill out the following form in addition to the above:

Adolescent Information Form


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 for Release of Information

 



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Helpful Forms

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