Forms

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

• Professional Disclosure Statement
• Client Intake Questionnaire
• Limits of Confidentiality/Therapy Cancellation Policy
• Client Contact Information Sheet
• Rates and Insurance
• Authorization for Credit Card Use

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

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