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Therapy for IndividualsCouples, & Families
Couple Therapy Session

Forms

If you're a new client, please print and complete the following forms and bring them with you to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

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:

  • Authorization to Disclose Information Form

 

Client Psychotherapy Intake Form  
Limits of confidentiality / Therapy Cancellation Policy  
Authorization to Disclose Information Form  

 

If you're a new neurofeedback client, please print and complete the following forms:

Consent for Neurofeedback
Checklist of Concerns



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

Schedule an appointment online!

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Thursday
7 Sep 2017
 
Friday
8 Sep 2017
 
Monday
11 Sep 2017
 
Tuesday
12 Sep 2017
 
Wednesday
13 Sep 2017
 
»
Appointment Scheduling by YellowSchedule.com
Jonathan Wieser
photo of Jonathan
Time zone:
(PDT)
Next available Appointment:
Sep 14th at 1:00 pm.
         
         
         
         
         
 
 
 
 
 
 
 
Kyla Moon
photo of Kyla
Time zone:
(PDT)
    1:00 pm      
    2:00 pm    
    3:00 pm    
    4:00 pm    
    5:00 pm    
    6:00 pm    
    7:00 pm    


If none of the dates and times available suit your schedule, please let us know and we will try to find a time that works for you.