Forms

Please fill out the forms below, then bring to your first appointment.

 

Professional Disclosure Statement

This form describes the nature of my practice, talks about me a little, and discusses confidentiality, etc.  For couples, please make sure to initial the relevant section.

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Intake Form

Completing this form will provide a comprehensive starting point from where we can begin our work together. I realize the form asks a lot of personal information from you - this will be the nature of our work together.

 

Couples Intake Form

Completing this form will provide a comprehensive starting point from where we can begin our work together. I realize the form asks a lot of personal information from you - this will be the nature of our work together.

 

Release of Information

This form is needed, only if applicable.  Please fill this out: if you're presently taking medication, are seeing another therapist or have a medical or mental health history that might be relevant to our work.