Forms

These are the forms you’ll need to start therapy. You can fill them out in the office before your first visit, or download, print, fill in, sign, and return to me.

Informed Consent Describes in some detail what you can expect from therapy and our work together.

Informed Consent_2017                  Informed Consent_TriWest_2017

Client Information Sheet is your name, address, DOB, medications, emergency contact, and more information that are important for our work together.

Client Information Sheet_2017                  Client Information Sheet_TRIWEST_2017

The Notice of Privacy Practices describes how I will protect your private information.

Notice of Privacy Practices

Authorization to Release Information You may or may not use this form. If we decide that my talking with your medical doctor, psychiatrist, or any other person in your life would benefit your work in therapy, you must give me your permission in writing to do so.

Authorization_to_Release_2017