Forms

Located here are the forms you will need for your first appointment. Please complete them and bring them with you. Your personal information is important to me and will assist me in helping you obtain the fullest benefit from therapy. You will also find my Privacy Practices and Client Rights form. You may print a copy for your records here or ask for a copy at the time of your first appointment.

Name	Size
Client-information-adult-011817.pdf Client information-adult 011817.pdf application/pdf Client information-adult 011817.pdf 170.49 KB May 11, 2023	170.49 KB
Client-information-child-adolescent-011817.pdf Client information-child-adolescent 011817.pdf application/pdf Client information-child-adolescent 011817.pdf 216.25 KB May 11, 2023	216.25 KB
Client-Rights-Privacy-Notice_docx.pdf Client Rights-Privacy Notice.docx.pdf application/pdf Client Rights-Privacy Notice.docx.pdf 216.77 KB May 11, 2023	216.77 KB
Fee-Contract-091118.pdf Fee Contract 091118.pdf application/pdf Fee Contract 091118.pdf 27.75 KB May 11, 2023	27.75 KB
Informed-Consent-for-Teletherapy_docx.pdf Informed Consent for Teletherapy.docx.pdf application/pdf Informed Consent for Teletherapy.docx.pdf 31.38 KB May 11, 2023	31.38 KB
Informed-Consent-Form-100719.pdf Informed Consent Form 100719.pdf application/pdf Informed Consent Form 100719.pdf 67.89 KB May 11, 2023	67.89 KB
Informed-Consent-Form-EAP-012821.pdf Informed Consent Form EAP 012821.pdf application/pdf Informed Consent Form EAP 012821.pdf 68.16 KB May 11, 2023	68.16 KB
Release-use-disclosure.pdf Release-use disclosure.pdf application/pdf Release-use disclosure.pdf 27.63 KB May 11, 2023	27.63 KB