Intake and Consent Forms

If you're a new client, please complete the following 4 forms and bring them to your first therapy session

The following forms are for you to print and review for your records. The following 2 forms do not require completion.

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 therapy information:


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

Contact Us

Location

Availability

Monday:

5:00 pm-9:00 pm

Tuesday:

5:00 pm-9:00 pm

Wednesday:

Closed

Thursday:

5:00 pm-9:00 pm

Friday:

Closed

Saturday:

By Appointment Only

Sunday:

Closed