Forms and New Patient Information
This page is currently in development. Thank you for your patience.
New Patient Information
Please provide information about you and your background prior to your first appointment, so I can best understand you and how to support you.
Informed Consent Form
Please review your rights and responsibilities prior to your first appointment, and sign that you understand and consent to therapy.
Release of Information
If you would like me to be able to share information about you with someone (such as your physician) to coordinate care, please complete this form.
HIPAA Information
Please review prior to your first meeting to understand how your protected health information is used and shared.
Policies and Procedures
Please review office policies and procedures.
Grievance Policy
Please review information about how to submit a grievance or report an ethics violation if you feel you have
Relationship Therapy Form
If you have scheduled to meet with me for relationship therapy, please complete this information about your relationship prior to our first meeting.
Clinical Supervision Form
If you have scheduled to meet with me for clinical supervision, please complete this information.