If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form
- Limits of Confidentiality/Therapy Cancellation Policy
- Informed Consent for In-Person Services During COVID-19
- Teletherapy Informed Consent Form
- Billing Registration Form
- Good Faith Estimate
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call (800) 985-3059
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:
Note: To download Adobe Acrobat Reader for free, click here .