Forms

Before your first session, I will send you all paperwork through my client portal. However, if you prefer, you may download a copy from this page and complete before your first session.

Intake Paperwork:

Child & Adolescent Clients:  PDF

Adult Clients: PDF

 

Telehealth Forms:

Before any telehealth sessions, please complete this additional consent form and review the included instructions: PDF

 

Additional Documents Needed:

For divorced parents of minor clients, please bring a copy of the custody agreement to the intake session so that I may verify who may consent to treatment.

If you wish to use insurance, please bring a copy of your insurance card with you.

If there are other people that I will need to be in contact with regarding your treatment, please print and complete the Release of Information Form: PDF

Privacy Policy:

This policy is included with all intake paperwork forms. However, you may also review a copy here: HIPAA Privacy Policy

No Surprises Act Notice:

The "No Surprises Act" protects consumers from unexpected medical bills. If you are choosing to use services as private pay or out-of-network, you have a right to receive a Good Faith Estimate that clearly outlines expected costs before your first session.