Forms

Prior to an initial session, please carefully read, print and bring these forms. Thank you.

• Adolescent Background Questionnaire
• Adult Background Questionnaire
• Client Registration Form
• Credit Card Consent Policy Form
• HIPAA Acknowledgement
• HIPAA Privacy Practices 
• Notice of Right to Receive Good Faith Estimate
• Outpatient Services Contract 
• Release of Information
• Telepsychology Consent Form

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Services

• Individual Therapy
  
• Adolescent Services
  
• Psychological Assessment

Schedule Online

For established clients only.  First time patients please contact me.