To be prepared for your first visit with us, please see below.

Section One: Print, complete, and bring to your first appointment: 

• Adult Psychotherapy Intake Form (18+)
• Child Psychotherapy Intake Form (Under 18)
• Child Psychotherapy Intake Form Cover Sheet (Under 18)
• Informed Consent
• Patient Care Communication Form
• Treatment Plan Acknowledgement Form
• Payment Acknowledgement Agreement Form
• Privacy and Rights Acknowledgement Form
• Health Risk Assessment (Adults Only Ages 18+)
• Health Risk Assessment (Child Only Ages 0-17)

Section Two: Reference/Read Only and/or Save/Print for your records:

• Consent for Treatment/Limits of Liability 
• HIPPA - Consent for Use and Disclosure of Health Information
• Patient Rights & 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

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