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FORMS

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CONFIDENTIALITY POLICY AND PRIVACY

INDIVIDUAL or FAMILY

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Required Forms:
 

  • Informed consent

  • Intake form

If you are a new client, please download and complete the required forms prior to your first session. You may leave blank any questions that you do not feel comfortable answering.

 

When booking online, Upload your completed forms to the Client File Upload Portal, which will appear on the Booking confirmation page at checkout. (We recommend using a program such as Adobe Acrobat Reader to complete and sign your forms)

For New Clients, you will receive a free 20-minute phone consultation prior to your first appointment

  • Authorization to disclose information

    (Please complete this form if you would like me to coordinate care with another provider, such as your physician or psychiatrist. This will allow your circle of care to work together and therefore, share necessary information.

PARTNERS

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Required Forms:
 

  • Informed consent

  • Partner: Marriage Counseling Intake Form

  • Authorization to disclose information

    (Please complete this form if you would like me to coordinate care with another provider, such as your physician or psychiatrist. This will allow your circle of care to work together and therefore, share necessary information.

If you are a new client, please download and complete the required forms prior to your first session. You may leave blank any questions that you do not feel comfortable answering.

 

When booking online, Upload your completed forms to the Client File Upload Portal, which will appear on the Booking confirmation page at checkout. (We recommend using a program such as Adobe Acrobat Reader to complete and sign your forms)

For New Clients, you will receive a free 20-minute phone consultation prior to your first appointment

CHILD COUNSELING

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Required Forms:
 

  • Informed consent

  • Child Counseling
    Intake Form

  • Authorization to disclose information

    (Please complete this form if you would like me to coordinate care with another provider, such as your physician or psychiatrist. This will allow your circle of care to work together and therefore, share necessary information.

If you are a new client, please download and complete the required forms prior to your first session. You may leave blank any questions that you do not feel comfortable answering.

 

When booking online, Upload your completed forms to the Client File Upload Portal, which will appear on the Booking confirmation page at checkout. (We recommend using a program such as Adobe Acrobat Reader to complete and sign your forms)

For New Clients, you will receive a free 20-minute phone consultation prior to your first appointment

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“Out of your vulnerabilities will come your strength”

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