Forms

Forms

Please complete the following form prior to our first session. This will allow more time to discuss your concerns. If you are attending counseling with a partner, each of you will need to complete your own forms.

Complete Prior to First Session

History & Registration

For your Reference

HIPPA Notice of Privacy Practices

Client Bill of Rights

No Surprises Act – Your Rights & Protection

If you’d like me to coordinate care with a primary physician, psychiatrist, or other therapist, please also print and complete this form.

Authorization for Release of Confidential Information