If you're a new client, please complete the following forms and bring them to your first therapy session.
- New Client Intake Form
- Acknowledgement of Receipt of HIPAA Privacy Notice
- Acknowledgement for Psychologist-Client Services Agreement
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:
The following form provides important information about my professional services and business policies. It also provides a summary of information about HIPAA (Health Insurance Portability and Accountability Act). Please read the form and ask any questions you may have at the first or second session.
The form below is the required HIPAA privacy notice.
Note: To download Adobe Acrobat Reader for free, click here .
