Intake Forms

Please choose the appropriate form below and print it and fill out before your initial appointment. Bring a hard copy with you and you will sign it at the start of the session to acknowledge the legal and policy agreements of the therapeutic contract.

Professional Disclosure Statement

HIPAA Privacy Statement

Adolescent/Teen Intake Form (to be completed by adolescent/teen if under 18)

Child/Adolescent Intake Form (to be completed by parent/guardian)

Individual Intake Form (if over 18)

Family Intake Form

Other forms

Credit Card Authorization

Release of Information