All new clients, please complete the following form and bring to your first therapy session.
Please complete the questiannaire that matches you as a client.
- Adult Questionnaire - adult clients only
- Couples Questionnaire - complete one form for each spouse/partner
- Teen/Adolescent Questionnaire - teen clients only
- Child Questionnaire - children under 13
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:
Please print, sign acknowledgement of Privacy Practices and Financial Policy prior to your initial appointment.
- General Privacy Practices - all clients
- Financial Policy- all clients
- Guidelines for Couples Counseling - couples only
- Adolescent Explanation of Privacy Practices - children 13 and over
- Consent for Treatment - all clients
If you do not have the ability to print these forms they are available in the office at time of first visit. If you are completing the forms in the office please arrive at least 30 minutes ahead of your scheduled appointment time.
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