Please fill out as completely as you can. Anything that is not filled out before the appointment will be completed at the beginning of the session. This is given to you in advance to try to minimize the amount of paperwork that will need to be done within the time constraints of our first session.
If you are coming in for couple or family counseling, just one of the adults can fill this out. If the primary client is a teenager, it is preferred that the teenager fill out this paperwork themselves. If you are filling this out for a child, please answer all questions as pertaining to the child.
The below forms will be sent prior to your initial session.
Intake Therapy Form
Disclosure Form
Additional Disclosure Form
Email Consent Form
If needed you can print out these below forms and bring to session.
If you would like me to coordinate care with another provider (for example your psychiatrist, primary care doctor etc.) complete the first form to authorize release of therapy information.
General release of information-new client.doc
The second form pertains to consent for insurance billing if you will be using insurance.
ROI-Insurance companies.doc