Intake Form
Click the button to complete the form before your intake/initial appointment. All information will be encrypted and sent using a secure form. Click the PDF icon to view.
Outpatient Services Contract
This form provides information about psychological services and my office policies, which we will review during the intake/initial appointment. Click the PDF icon to view.
HIPAA Notice of Privacy Practices
This form provides information about how the Health Insurance Portability and Accountability Act (HIPAA) protects your health information, and how I may use and disclose such information. Click the PDF icon to view.
Release of Information Authorization
This form allows me to share information with specific individuals and other health providers. Click the PDF icon to view.
