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New Client Forms

If you are a new client, please be sure to print and complete the Treatment Agreement/Intake Form. *If you are attending couples counseling, please have each partner fill out their own Intake portion of this form. Thank you.

Please also note the HIPPA Notice of Privacy Practices document at the end that is only for your reference and does not need to be printed or brought into the therapy session.

Additionally, if you would like me to coordinate care with another provider (for example, your previous therapist, your psychiatrist, your primary care physician, etc.), please complete this Authorization for Release form to authorize release of psychotherapy information. It is often useful in providing continuity of care among health care providers if I am given permission, by you, to contact them for information that might aid in our work together. This is particularly helpful if you have been seeing another therapist or psychiatrist for therapy in the past or if you are currently being prescribed psychiatric medication, such as anti-depressants or anti-anxiety medications.

Please read these forms, sign where indicated, and bring them to our first meeting. We will discuss them at our scheduled intake meeting together.

If you have any questions about the forms, certainly feel free to contact me by phone or email and I'll be happy to discuss them with you prior to our session.