New Patients

Forms

If you’re a new patient, please complete the following forms and bring them to your first therapy session,

• Adult Patient Intake Form I
• Adult Patient Intake Form II

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

• Authorization to Disclose Information Form

Privacy & Policies

The following document details my privacy policy and practices:

• Notice of Policies and Practices to Protect the Privacy of Your Health Information