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Client Forms

Please complete these forms to the best of your ability and bring them to our first session.

  • Consent to Treat
    • This document contains important information about my professional services; the purpose of therapy, benefits and risks as well as my business policies regarding your participation in therapy. Please read it carefully and come prepared with any questions.
  • Client Intake Questionnaire
    • This document will give me information about you that will speed up the first session and help with future sessions. It will also help with basic contact information and your previous history.This document will give me information about you that will speed up the first session and help with future sessions. It will also help with basic contact information and your previous history.
  • Notice of Privacy Practices
    • The HIPAA Privacy Rule requires health plans and covered health care providers to develop and distribute a notice that provides a clear, user friendly explanation of individuals rights with respect to their personal health information and the privacy practices of health plans and health care providers. This page provides options for meeting the requirement to create notices of privacy practices (NPP).
  • Authorization for Release of Information
    • Fill out the this form if you feel that you would like to collaborate your session with another provider.