Client Forms
Consent to Treatment
Telehealth Consent
Registration
Adult History Form (ages 15+)
Child/Adolescent History Form (up to age 15) *For GUARDIAN to complete*
OPTIONAL: Child/Adolescent History Form (up to age 16) *For CHILD to complete*
HIPAA Privacy Policy and Client Rights
Financial Policy
Authorization to Release Information
This authorization from will allow me to share personal health information with whomever you choose. For example, you may want me to coordinate efforts with a psychiatrist or with your medical doctor.
Complete Here
Professional Disclosure Form
I am required by law to provide this document to you. It summarizes my educational background, my approach to counseling and outlines my court fees. It also provides the addresses to which you write if you need to file a formal complaint against me.
EMDR Informed Consent
Please complete this form if you are considering EMDR treatment.
Complete Here