Counseling Services

Individual
Couples & Family
Relationship Issues
Grief and Loss
Anxiety and Fears
Dissociative Identity Disorder Panic Disorder
Post Partum Support
Complex PTSD

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Required Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

Individual, Adult and Couples Intake Form



Child and Teen Intake Form



Pregnancy and Postpartum Intake Form


Limits of Confidentiality/Therapy Cancellation Policy




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:



Authorization to Disclose Information Form





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

Helpful Forms

Click here to view and print forms for your appointment

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