NEW PATIENT FORMS:

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

• Patient Intake Form
• Patient Information Form - Digital

Please download, read and retain the Health Information Portability and Accountability Act (HIPAA) Information Packet.

• HIPAA Information

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:

• Consent to Consult Form

EMDR CONSULTATION FORMS:

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

• Weekend 1 Flyer
• Weekend 1 Registration Form

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

• Weekend 2 Flyer
• Weekend 2 Registration Form

To register for Certification Consultation, download the Registration Form.

• Certification Registration Form 

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

• Consultant in Training (CIT) Consultation Registration Form

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