If you're a new client, please complete the following forms and bring them to your first session. For your privacy, please do not email any sensitive information. Your intakes may, however, be faxed, mailed, or brought in person.

• Adult Client Intake Form
• Teen/child Intake Form
• Limits of Confidentiality/Cancellation Policy Form
• Client Insurance Verification Form
• FWC-Anchor Registration/Disclosure Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form:

• Consent to Release Information Form

Note: To download Adobe Acrobat Reader for free, click here.

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Please don't put anything here: Your Name:

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.