Client Forms

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

• Client Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
• Informed Consent for Treatment Services
• Tele-Mental Health Inform Consent
• Guarantor/Responsible Party Agreement
• Credit Card on File Form
• Consent to Unsecure Electronic Communication 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 to Disclose Information Form

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

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