Helpful Forms

NEW PATIENT FORMS:

If you're a new patient, please complete the following forms and return them to me prior your first therapy session.

New Patient Form

Please read and retain this:

Health Information Portability and Accountability Act (HIPAA) Information Packet.

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

Authorize the Release of Psychotherapy Information

EMDR CONSULTATION FORMS:

To register for Weekend 1 Basic Training Consultation, download this flyer and Registration Form.

To register for Weekend 2 Basic Training Consultation, download this flyer and Registration Form.

To register for Certification Consultation, download the Registration Form.

To register for Consultant in Training (CIT) Consultation, download the Registration Form.

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