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Senior Citizen Couple
Senior Citizen Couple

Forms

If you're a new client, please complete the following forms and submit them to me in advance.

IMPORTANT: If we are meeting online you will need to send these forms to me through my HIPAA compliant Zoom account. You will need to create a Zoom account (here). Please include your email address when you schedule your appointment with me so that I can add you as a contact. 

 

 

 

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



Note: To download Adobe Acrobat Reader for free, click here. You will be able to fill in the form and sign using Adobe on your desktop computer or by using the app on your mobile device. 

Helpful Forms

Click here to view and print forms for your appointment.

Click Here