For New Clients
If you are a new client, click each of the following links to download the new client forms. Please print, complete, sign and bring these to your first appointment. (The forms will take about 30 minutes to complete.)
Authorization for Disclosure: This form gives me legal authorization to contact a designated person with whom you may want me to have contact with. For example; a medication prescriber or another family member.
Informed Consent: It is required by law for me to provide you with this information sheet that outlines what you can expect from therapy, what laws govern counseling as well as my fees and payment schedule.
Privacy Practices: This notice describes how clinical information about you may be used and disclosed and how you can get access to this information.
Insurance Billing Form: If you choose to pay for therapy using a third party payer such as a community agency or insurance company, I will typically submit authorization and claim forms directly to them.
Registration Form: This is your personal information such as address, phone, etc.
Personal Information Form: A 3-page form that details your your personal and family history and what brings you to counseling.