Now providing telehealth (video counseling) for Self-Pay patients and patients with selective insurances!
Please contact your health insurance for authorizations or specific coverage information.

Forms

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.

Contact Us

Location

Availability

Monday:

9:00 am-9:00 pm

Tuesday:

9:00 am-8:00 pm

Wednesday:

9:00 am-8:00 pm

Thursday:

9:00 am-8:00 pm

Friday:

9:00 am-8:00 pm

Saturday:

Closed

Sunday:

Closed