If you’re a new client, please complete the following forms and bring them to your first therapy session.
Limits of Confidentiality/Therapy Cancellation Policy
Individual Therapy Written Consent
Children’s Therapy Written Consent
Integrative Medicine Acupuncture and Psychotherapy Written Consent
HIPAA Notice of Privacy Practices
HIPPA Acknowledgement Receipt of Privacy Practices
Insurance Information Form
Credit Card Authorization Form
If you are participating in couples therapy, please complete the following forms and bring them to your first therapy session.
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:
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