Prep Forms

Forms to fill out prior to your first visit.

Client Information Forms

Print and fill out the appropriate form.

Download: Adult Intake Form

Download: Child Intake Form


HIPAA Forms

1. This Therapist Client Agreement is provided to allow you to add a copy to your own files and does not require a signature.

Download: Therapist Client Agreement

2. This HIPAA form notifies you of our privacy policy and does not need a signature.

Download: Notice of Privacy Practices

3. This is a consent form to participate in Telehealth Therapy Services.

Download: Consent To Participate in Telehealth Therapy Services

4. This is a consent and information form for Psychotherapy for Children and Their Families Proceeding Through Separation and/or a Divorce Process

Download: Informed Consent Regarding Psychotherapy for Children and Their Families Proceeding Through Separation and/or a Divorce Process

5. This is a consent Regarding Co-parenting of Separated And/or Divorced Couples

Download: Informed Consent Regarding Co-parenting of Separated And/or Divorced Couples

6. By signing this form you are agreeing to our HIPAA policies as well as authorizing us to bill your insurance

Download: HIPAA Client Acknowledgement


Referral & Release Form

7. A copy of our referral form is available here.

Download: Referral Form

8. Our Information Release Form is available here.

Download: Information Release Form