Forms

Please complete the intake paperwork in its entirety and bring with you to the first appointment that we schedule. Clients 18 years of age and older please use the adult client paperwork, and clients under 18 please use the child client paperwork. If you have any questions about the paperwork, please contact me or we can talk about this during our appointment. If you are not able to bring the paperwork with you please let me know, and I can have the forms printed for you to complete 20 minutes before the start of the session.

For clients who are under the age of 18, please have your guardians/parents sign the forms. **The forms need to be signed and initialed by both guardians/parents in order for the counseling process to begin. Thank you.

Intake Paperwork – Adult Client

Intake Paperwork – Child Client

HIPAA Privacy Policy Consent for participation in the counseling process/Release of Information form

Additional Forms

Good Faith Estimate

Telepractice Release

Consent for participation in the counseling process/Release of Information form

Request for Documentation

Credit Card Authorization

Agreement in the context of divorce, separation, transfer of caregivers