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client forms and information

Please feel free to make copies of these forms for your own records - or you may return to this site for future reference or clarification at any time.

               Intake Form                   HPPA Form          

If you would like for me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc), .please click on the Medicial Release button below, print a copy of the form and fill it out to authorize release of psychotherapy information.  Scan it and email me a copy or bring it with you to your next session for me to keep on file.

To view copy of my current professional 

license, click on: 

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