If you are a new client, please complete the following forms and bring them to your first therapy session.
- Limits of Confidentiality/ Cancellation Policy
- Client Information Form
Adult Intake Form
If you are coming for couple counseling, please complete all of the above forms, substituting the following form in the place of the "Client Information Form" :
Please make two copies of the Adult Intake Form and the Couple Counseling Questionnaire, one for each person to complete. Please do not share your answers for the Couple Counseling Questionnaire.
Authorization to Disclose Information:
If you would like me to coordinate care with another person (for example, your primary care physician, psychiatrist, family member, etc.), please complete this form to authorize release of information:
Note: To download Adobe Acrobat Reader for free, click here