Forms

Please download the following forms and bring with you to your first session. If you have any questions about any of these forms, you can email me or we can discuss them when we meet.

Adults (18+)

  1. Adult Intake (please complete in full)
  2. Informed Consent (please read and bring in pages 5 and 6)

Adolescents (Ages 16-17):

  1. Adolescent Intake (for parent to complete)
  2. Adolescent Self-Report (for teen to complete)
  3. Informed Consent (please complete pages 5 and 6)

Patient Notification of Privacy Rights

Patient Bill of Rights

For information about therapy fees, click here.