Forms
If you are a new client, please complete the following forms and bring them to your first appointment.
~ To PRINT Intake Form, click below
Note: To download Adobe Acrobat Reader for free, click here.
~ For Online Intake Form, click here.
If you are not a client, but have general questions, click below
Confidentiality & Privacy Policy
The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Exceptions include:
Suspected child abuse, dependent adult or elder abuse, for which I am required by law to report to the appropriate authorities immediately.
If a client is threatening serious bodily harm to another person(s), I must notify the police and inform the intended victim(s).
If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.