Forms For New Clients

FormsO3The following forms and documents are part of the intake process. If you have made an appointment, please print out the forms, complete them, and bring with you when we meet. Alternately, you can complete all information online via my secure client portal. Please give me your email address, and I will send you an invitation to the portal.

Please read the Psychotherapy Client Information Package for details about therapy and office practices. We can discuss any questions you have at our meeting.

Psychotherapy Client Information Package – contains information about my practice, confidentiality, my office policies, and privacy and confidentiality in records/information management – for all clients
Psychotherapy Service Agreement – One page agreement form detailing fees, cancellation, and appointment reminders – for all clients
Client Information and History Form – basic information sheet.
Client Intake Questionnaire – questions about multiple areas of your life.
Release Form – complete if there is someone else you would like me to be able to speak to and agree to release confidential information to, such as a primary care physician, a psychiatrist, or a former therapist.

FormsO1Forms For Eating Disorder Clients

Eating Disorder Questionnaire – questionnaire about eating disorder history and behaviors.

All documents are provided in Adobe PDF format. If you don’t already have the free Adobe PDF Reader, click here.