If you are a new client, please complete the following forms and bring them to your first therapy session.
- Client Intake Form
Information, Disclosure, and Consent Form
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:
Authorization For Use or Disclosure of Protected Health Information Form
- Mental/Behavioral Health Insurance Benefits Verification Form
|Client Intake Form|
|Information, Disclosure, And Consent Form|
|Confidentiality/HIPAA Practices Form|
|Authorization For Use/Disclosure of Protected Health Information Form|
|Mental/Behavioral Health Insurance Benefits Verification Form|
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