Intake Forms



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

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 to Disclose Information Form
  Client Psychotherapy Intake Form
  Limits of Confidentiality/Therapy Cancellation Policy
  Authorization to Disclose Information Form

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


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Helpful Forms

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