If you are a new client, please print and complete the following forms and bring them to your first therapy session:
1. Registration: /userfiles/2442060/file/Registration Form.pdf
2. Outpatient Services Contract: /userfiles/2442060/file/Outpatient Services Contract 01_01_2017.pdf
3. Insurance/Financial Contract: /userfiles/2442060/file/Financial Agreement Insurance Contract 11_2015.pdf
4. Clinical Packet For Adult Patients: /userfiles/2442060/file/CCA Adult.pdf
5. Clinical Packet For Patients under the age of 18, parent/guardian complete this clinical packet: /userfiles/2442060/file/CCA-Child 01_18_2017.pdf
6. Consent For Release of Information: IIf 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 information: /userfiles/2442060/file/Authorization to Obtain andor Release Information 01_01_2017.pdf
Note: To download Adobe Acrobat Reader for free, click here.