Forms

Notice of Privacy Practices 2017-08

Informed Consent 2017-08

Informed Consent – Minor – 2017-09

Intake 2017-08

Intake – Minor- 2017-09

Please print, complete and bring these forms to your first appointment.

The Notices of Privacy Practices outlines how I will protect your private health information, and your rights related to this protection. The Informed Consent document is our agreement: what you can expect from therapy and from me, and what I can expect from you. The Intake document provides me with your contact information, some demographics, and a brief overview of your concerns.

Please ask me if you have any questions or concerns, or would like any clarification.