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Helpful Forms

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

  • Client Intake Form

  • Limits of Confidentiality/Cancellation Policy Form


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

  • Consent to Release Information Form

Client Intake 
Limits of Confidentiality/Cancellation
Consent to Release Information
Informed Consent for Therapy
Authorization for Use or Disclosure
Adolescent Biographical Information
Adult Biographical Information
Notice of
Privacy Practices
To view these PDFs, 
make sure you have Adobe Acrobat Reader Installed.
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