Intake Froms: If you're a new client, please complete the following forms and bring them to your first therapy session.
- Depression/Anxiety Scale (Please have each person attending therapy complete their own copy of this form)
- Informed Consent Document (Please print one copy of this form and have each person attending therapy read and sign it)
- HIPAA Regulations & Privacy Policies (For your reading pleasure, no need to print)
- Limits of Confidentiality (Please print one copy of this form and have all attending therapy read and sign it)
- Financial Responsibility Form (Please print one copy of this form and have all people attending therapy complete and sign it)
- Demographic Information Sheet (Please print one copy of this form and complete it)
In-depth Personal History Form: This form is to dig deeply into many aspects of ones life. Clients are asked to fill this if and or when needed.
- In-depth Personal History Form (Please have each person attending therapy complete their own copy of this form)
Relationship Questionnaire: If you are coming in for any form of couple/relational (Married, Co-habitating, Partner, Significant Other or Premarital) work please have each person in the relationship complete a copy of the form below.
- Relationship Questionnaire (Each person attending therapy should complete their own copy of this form)
Release Form: If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.) or any other person, complete this form to authorize release of psychotherapy information.
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