Forms

If you're a new client, please complete the following forms and bring them to your first therapy session, or email them to: [email protected]

• Client Psychotherapy Intake Form
• Client Psychotherapy Intake Form.PDF
  
  
• Informed Consent
• Informed Consent.PDF
  
  
• Mental Health Questionnaire
• Mental Health Questionnaire.PDF
  
  
• Consent for EMDR Therapy Form
• Consent for EMDR Therapy Form.PDF
  
  
• PTSD Checklist
• PTSD Checklist.PDF
  

• History form
  
• History form.PDF

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

• Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.