New Patient Form

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

  • Client Psychotherapy Intake Form

  • Limits of Confidentiality/Therapy Cancellation Policy

  • Insurance Information

  • Client Consent and Agreement to Receive Psychological Services

  • Patient Bill of Rights/Responsibilities

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.