PLEASE READ, DOWNLOAD, PRINT, AND COMPLETE THE BELOW FORMS TO BRING TO YOUR APPOINTMENT. QUESTIONS REGARDING THESE FORMS CAN BE ADDRESSED AT YOUR FIRST APPOINTMENT.

Click here for the Consent to Treat Form     

Click here for the Adolescent Informed Consent and Parent Agreement to Respect Confidentiality Form (This form only needs be completed by adolescents and their parents)  

Credit Card Agreement

HIPPA-Notice of Privacy Practices (This form only needs to be read. It does not need to be completed.)

HIPPA Receipt and Acknowledgement 

Initial Intake (Please complete this form and bring it to your first session.)

Notification of Breach of Protected Health Information

Outpatient Services Contract

Release of Information (This only needs to be completed if you would like me to share your protected health information with another provider, person or agency.)