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

• Client Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
  

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

• Authorization to Disclose Information Form

If you would like to use your Insurance complete the top portion of this form and fax or mail it to me before our first session to determine your benefits. This is the form that will be used to submit to the Insurance company for payment.

Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form

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