For new clients, please complete the Intake Form and the appropriate History form.
When finished there are two options:
- Print and bring form for an in office visit (or)
- Save the files and e-mail to [email protected] for a TeleHealth session.
- Personal History (Choose One)
- Children/Adolescent History (for less than 18 years old)
- Adult History (18 and up)
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:
For Your Information
Note: To download Adobe Acrobat Reader for free, click here.