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Helpful Forms

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

  • Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like me to coordinate care with another provider (for example, your psychotherapist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

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

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

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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Helpful Forms

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