Patient Forms & Policies

If this is your initial appointment with our office, please complete the following two forms and scan them back to the e-mail at the top of the page on the forms:

• Reason For Visit Form
  
  

Choose from the following as per your request for either evaluation or treatment:

• INFORMED CONSENT FOR TELEHEALTH - Treatment                                   
                                                    or
• INFORMED CONSENT FOR TELEHEALTH - Evaluation
  
  

If you would like me to communicate with another provider (for example, your primary care provider or other therapist) please complete the below Authorization to Release Confidential Information form and scan it back to my e-mail.

• Authorization to Release Confidential Treatment Information

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