Helpful 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

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

LOCATION

Availability

Primary

Monday:

Availability Upon Request

Tuesday:

Availability Upon Request

Wednesday:

Availability Upon Request

Thursday:

Availability Upon Request

Friday:

Availability Upon Request

Saturday:

Closed

Sunday:

Closed

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