- Client Psychotherapy Intake Form
- Adult Checklist of Concerns
- Limits of Confidentiality/Therapy Cancellation Policy
- Consent to Treat
- Information for Clients
If your child will be the primary client, please complete and bring:
- Client Psychotherapy Intake Form, Child / Teen
- Child Checklist of Concerns
- Child Developmental History
- Limits of Confidentiality/Therapy Cancellation Policy
- Consent to Treat
- Information for Clients
For children and teens ages 10 and above, please also read and bring to the first session:
This form explains how I manage confidentiality for older children and teens. Please feel free to bring any questions you or your child may have as well!
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.