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New Client Forms

If you're a new client, please complete the following forms and bring them to the initial consultation:

  • Consent to Psychotherapy
  • Client Intake
  • Credit Card Agreement (optional)

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

  • Release of Information

If the client is less than 18 years old, please bring the following forms completed and signed to the initial consultation:

  • Permission to Treat a Minor

 

Consent to Psychotherapy read and sign and bring with you to your appointment
Release of Information only necessary to consult with other professionals regarding treatment and disgnosis
Permission to Treat a Minor signed by the parent or legal guardian when the client is less than 18 years old
   
Client Intake one filled out by each client participating
Credit Card Authorization optional

 

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Helpful Forms

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