Forms ( Please Read Instructions Carefully! )

Your willingness to complete this paperwork before your appointment is appreciated. It allows you to start your first session immediately with an evaluation of your problems and needs. If you have any questions, feel free to call. Otherwise, we are looking forward to meeting you in person soon.

This section contains paperwork needed to begin counseling and psychotherapy treatment. Documents listed below are needed for each client of all ages:

1. Client Agreement
Please read this document carefully (no need to print it out). It reviews my office practices and policies.

2.  Notification of Privacy Practices
Please read this document carefully (no need to print it out). It addresses the privacy of your records.

3.  Consents and Authorization
Please print out and sign this one page agreement. Bring it with you to the first session.

4. Registration Form
Please print out and complete this one page. Bring it with you to the first session

5. Financial Agreements



Adult Forms

If you are 18 years or older, please complete these forms prior to your first appointment


Medical Health History and Addiction Screening

Symptom Inventory

Release of Information



Child Forms

Parents, please complete these forms for you child who is under the age of 18.


Development and Medical History for Children

Release of Information