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Helpful Forms


Late cancellations (less than 24 hours prior to appointment) are charged a $50.00 fee.

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

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

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

  • Authorization to Disclose Information Form
Client Psychotherapy Intake Form  
Limits of Confidentiality/Therapy Cancellation Policy  
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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