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The future depends onwhat you do in the present
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Helpful Forms

 

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

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

 

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 to Disclose Information Form

Client Psychotherapy Intake Form  
Limits of Confidentiality/Therapy Cancellation Policy  
Authorization to Disclose Information Form  

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

If you are a facility seeking psychological testing services, please complete the following
Psychological Testing Referral

form and fax it to our office at 866-372-5885.

For all individuals requesting psychological testing services, Prior to the date of service, please complete the following forms and bring them to the appointment with you to expedite the process.