• Notice of Privacy Practices

If you’re a first-time client, please review and complete the following forms and bring them to your first session.  The first three forms must be filled out and brought to the first appointment.  The Notice of Privacy Practices is at the top of this page.  Please read it to be informed about HIPAA.

• Client Intake Form — Please fill this out and bring to the first appointment
• Informed Consent – Please fill this out and bring to the first appointment
• Receipt of Privacy Practices — Please sign and bring to the first appointment

Please fill out this form if you are coming in for couple of family counseling.

• Confidentiality Policy for Family and Couples Therapy

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete these forms:

• Authorization to Exchange Protected Health Information

If you would like to pay by credit card, please fill out this form:

•   Credit Card Authorization

Please fill out this form if you are participating in telehealth.

•  Telehealth Consent Form

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