Forms

intake-forms-clipboardIf you are a new client, please print and complete the following two forms–the Client Intake Form and Informed Consent for Treatment–and bring them with you to your initial visit. If you are visiting us as a couple, each person will need to print and complete both forms separately.

If it is more convenient, you are welcome to arrive at my office about 20 minutes prior to your initial session and fill them out in the waiting room. If you choose this option, please notify me in advance, so I can leave the forms out for you.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information:

Note: To download Adobe Acrobat Reader for free, click here.