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Helpful Forms

For new clients, there are two forms that must be completed and signed before counseling services may begin.  The intake form collects contact information and health history that you might wish to provide.  The confidentiality form provides information about any limits on the confidentialty of counseling sessions.  I will email the links for these forms to you through a service that allows you to complete and sign the forms and then send them back to me.  If you would like to view the forms before they are emailed to you, you may click on the links below.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), a form to authorize communication and release of counseling information is required.  You may view this form by clicking on the link below.  If you wish to proceed with the authorization, I will send you a link to the service that will allow you to complete and sign the form before the form is sent back to me.

Note: The above forms are provided in pdf format, to view the forms you must have Adobe Acrobat Reader on your computer.  To download a free copy of Adobe Acrobat Reader,
click here.

Helpful Forms

Click here to view and print forms for your appointment.