If you are a new client, please complete the client Intake Form, the Telehealth Consent Form, and the Fee Policy and Credit Card Authorization. Before your first appointment please print and email the forms to me at [email protected] Please contact me if If you have questions.
Also, please review the Notice of Privacy Rights (HIPAA), and the Counseling Agreement before your appointment.
|Telehealth Consent Form|
|Fee policy & Credit Card Authorization|
|Notice of Privacy Rights|
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:
|Spectrum Release of Information|
Note: To download Adobe Acrobat Reader for free, click here .