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Helpful Forms





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

  • Client Information Form
  • Checklist of Concerns
  • Limits of Confidentiality/Therapy Cancellation Policy

Client Information Form  
Limits of Confidentiality/Therapy Cancellation Policy  
Checklist of Concerns  

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

  • Authorization to Disclose Information Form

Authorization to Disclose Information Form  

Note: To download Adobe Acrobat Reader for free, click here.


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Helpful Forms

Click here to view and print forms for your appointment.

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