Individual, couples, and family counseling

for adults and children

Children


  • Professional Disclosure Statement
  • Consent to Treat a Minor Child
  • Credit Card Authorization
  • Authorization for Release of Information. (if you would like for me to be able to discuss your history with previous therapists or medical professionals; there must be one form completed for each contact)

Adults


  • Professional Disclosure Statement
  • Consent to Treatment for Adults
  • Credit Card Authorization
  • Authorization for Release of Information (if you would like for me to be able to discuss your history with previous therapists or medical professionals; there must by one form completed for each contact)


New Clients


Please complete the following paperwork prior to your first appointment and bring it with you to your session: