Helpful Forms

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

    • Consent to Treatment
    • Privacy of Information Policies

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

    • Release of Information

Consent to Treatment Describes the nature and anticipated course of therapy, fees, and limits of confidentiality.
Privacy of Information Policies Describes the standards of disclosure of protected health information.
Release of Information Provides written permission from the client to release or obtain protected health information.

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



Contact Me

Location

Availability

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed