FORMS

Below are the intake forms required prior to beginning treatment. After we have set up an initial appointment, please print and complete the applicable forms and bring them with you to your first session. Doing so will save us time in our first session. If you are unable to print them or wish to talk with me about them in person, I will provide you with copies in my office and answer any questions you may have. The information provided in these forms will become part of your confidential file, to which I alone have access.

Family Intake Form

This form is for Family Therapy. Parents or legal guardians should complete this form.

Couples Intake Form

Please fill out this form to begin Couples Counseling prior to your first visit. Each individual should fill out their own form.

Individual Intake Form

Please fill out this form prior to your first visit for Individual Therapy.

Client Information and Consent

Please read, sign and return this form prior to your first appointment. This form contains general information about appointments, cancellations, fees, confidentiality, and more.

Consent to Release Information

Before speaking with anyone about you or your child, I need your written permission. This form allows me to speak with relevant professionals in your treatment team when necessary (ie: doctor, psychiatrist, school counselor). I will let you know when/if I need this form filled out.