Helpful Forms

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

Professional Disclosure and Treatment Contract

Family Therapy Intake Form

Consent to Release Confidential Information to Insurance Company

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

Consent to Release Form

If you would like to provide feedback on how your therapy sessions have been at any time throughout the process, please click the link below to complete online, or download the below Customer Feedback Form Microsoft Word document and submit via email, fax or postal mail:

Click Here to take survey

Customer Feedback Form

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