Menu

Helpful Forms

Please complete to following forms for your appointment:

/userfiles/2079575/file/Disclosure Statement.pdf

/userfiles/2079575/file/Child Information Form(1).doc

/userfiles/2079575/file/BibliographicalInformationForm.pdf

/userfiles/2079575/file/TeletherapyAddendum.pdf

/userfiles/2079575/file/covid19.pdf

If you would like me to coordinate care with another provider, psychiatrist or medical doctor please complete the following form userfiles/2079575/file/HIPPA Authorization Form.pdf


If you would like to preview a copy of our Privacy Practices, please view it here: userfiles/2079575/file/privacypractices.pdf


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

Helpful Forms

Click here to view and print forms for your appointment.

Click Here