“Happiness is not something you postpone for the future; it is something you design for the present.”   

– Jim Rohn, Entrepreneur, Author, and Motivational Speaker

If you are a new client, please print and complete the following forms and scan them to me prior to our initial appointment, or bring them in to your initial appointment. Due to unforeseeable circumstances such as illness, please also complete the Telemedicine Consent form even if you are scheduled for in-office sessions.

• Consent to Treatment (For all clients to complete and return)
• Notice of Privacy Practices (For all clients to review)
• Acknowledgement of Receipt of Privacy Practices (For all clients to complete and return)
• Intake Form-Adult (For all clients to complete and return)
• Depression Assessment (For all clients to complete and return)
• Anxiety Assessment (For all clients to complete and return)
• Telemedicine Consent (For all clients to complete and return)
• Beacon Member Rights and Responsibilities (For all Beacon/Carelon clients to review)
• Notice of Good Faith Estimate (For private-pay clients to review)

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

• Release of Information (Optional for all clients)