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Dear Client,

Below are the forms I am required to provide for you. You will need certain forms at certain times in our work together. You may complete them and bring them to your appointment  or email them to me. Please don't hesitate to contact me with any questions.  

One Per Client

Client Information is requested for each client, whether coming individually or as a couple or family. It tells me a little about your background and gives you an opportunity to tell me anything you want me to know ahead of our session. Please complete and bring to your appointment or email to me. 

Couples and families may sign on the same form for the following required forms:

Disclosure provides you with information about me, my policies and your rights as a client. If you're coming as a couple or a family, you only need to sign on one form.

HIPAAnotifies you of the privacy of your medical records.

Teletherapy gives consent to conduct remote sessions by phone or video.

Unsecured Communication provides information around electronic communication.


The remaining forms will only be requested if there is a specific need in our work together.

Collateral is required for you to give permission for another person to attend one or more of your sessions.

Release of Information is required if you want me to share information about our work together with another person.

Covid is a waiver in case there is increased risk of Covid infection.

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