Intake and Authorization Forms

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


Client Intake Form
Confidentiality and Cancellation Policy
Credit Card Authorization Form


If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

Consent to Release


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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