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Client Forms

 

Please complete this form for yourself or, if you are a parent seeking treatment for your child or children, please fill out this form for them.  If you are seeking couples therapy, each partner needs to fill out a separate form.  Please bring the completed form with you to the first appointment.

Client Information Form
 

Please review, print out and sign this form, and bring it with you to your first appointment.

 

Please review, print out and sign this form, and bring it with you to your first appointment. 

 

Please print out this form, complete it and sign, if you would like me to communicate with your physician, psychiatrist, former therapist, attorney or any other party or agency.

 

Please review, complete and sign this form if you are seeking treatment for your child or children.  In the case of divorced or divorcing families, I will need both parents to sign a consent unless there is a court order giving you permission to seek treatment on your child's behalf without the permission of the other parent.  Please bring the signed form to the first appointment.

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