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 .

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