Helpful Forms

                                   

                                                            Please start here if you're a new client, and complete the following forms and then contact our office to schedule.  

                                                            We are currently scheduling as early as within a couple of weeks with one or two providers, and as late as 4-8 months 

                                                            with other providers.  Thank you.

• Online New Client Registration Link                 
• Agreement for Services/ Card on File Form
• Protected Health Information Privacy Notice (for Your Info)
• Please email if you are having difficulty with the registration [email protected]
• If returning or additional documents are needed PLEASE see DOCUMENTS BELOW- THANK YOU!!
• Agreement for Services/ Card on File Form
• Copay Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information:

• Authorization to Release Information
• Authorization to Release Records/ Reports

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