Forms

bird in a tree

If you are new, please fill out these intake forms prior to our first session and return them to me at this secure, privacy (HIPPA) compliant email address: [email protected].

Client Psychotherapy Intake Form

Information Sheet

Limits of Confidentiality/Therapy Cancellation Policy

Payment, Missed Session and Cancellation Policy

If you have any questions, feel free to be in touch with me. I’d be happy to discuss them with you prior to the submission of your completed forms.

Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.

Contact Today

Office Hours

Monday  

10:00 am - 4:00 pm

Tuesday  

10:00 am - 4:00 pm

Wednesday  

Closed

Thursday  

10:00 am - 4:00 pm

Friday  

10:00 am - 4:00 pm

Saturday  

Closed

Sunday  

Closed