If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form (Adult OR Child)
- Assignment of Benefits
- Consent for Treatment
- Credit Card Authorization (to keep on file for copay/coinsurance)
- HIPAA 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 (Optional)
Note: To download Adobe Acrobat Reader for free, click here.