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Interracial Couple

Helpful Forms

If you're a new client, please print, complete the following forms and bring them to your first therapy session.  Please Note:  There will be a few other documents that will need to be also signed in your first session with me present.  

 



INDIVIDUAL THERAPY

If you would like me to coordinate care with another provider (for example, your psychiatrist, previous therapist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

 

 


COUPLES THERAPY  (Each partner needs to print and complete each form for self)

If you would like me to coordinate care with another provider (for example, your psychiatrist, previous therapist, primary care physician, etc.), complete this form to authorize release of psychotherapy information.  Both partners must complete and sign their own form for each provider.

 

 

 

 Important information:  Please read to be informed, you do not need to print

 

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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