Intake Forms

As of March 2020, all appointments are virtual appointments due to the COVID-19 pandemic.  All clients must review, initial and sign my Telehealth Informed Consent:

• Telehealth Informed Consent

If you're a new client, please complete the following forms and bring them to your first therapy session.

• Client Information Form

• Release of Information for Primary Care Provider
• Release of Information for Insurance Company
• HIPAA Notice of Privacy Practices
• Signature Page for HIPAA Notice of Privacy Practices

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