Helpful Forms

If you're a new client, please complete the following forms and bring them to your first session. I will go over privacy, billing, and other information in greater detail at your session.

Client Intake Form Information about you. 

Client Informed Consent This is helpful information for you. It explains what to expect in therapy and who attends, financial policy, cancellations, privacy, coordinating with other providers, mandating reporting, and my background. 

I cannot talk, email, or communicate information about you with anyone unless I have a release of information form signed by you or your parent/guardian. If you would like me to coordinate care with another provider (psychiatrist, primary care doctor, teacher, county worker, etc.), complete the Client Release of Information form to authorize release and/or to obtain certain information on your therapy.  

To know more detailed information about how I use information, your rights, and under what circumstances I don't need a release of information, read and sign this: Notice of Privacy Practices 

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