Helpful Forms


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

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 forms below are for your information.  Please review them.
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 .

Helpful Forms

Click here to view and print forms for your appointment.


Michael L. Stern, PhD
60 Old New Milford Rd.
Suite 3B
Brookfield, CT 06804
[email protected]

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