top of page
Client Forms
Please click on the links below to review documents and learn more about my practice.
These forms will need to be read, completed, and signed prior to your first session to comply with state and/or federal regulations and/or legal and/or ethical obligations.
![Plant Box](https://static.wixstatic.com/media/28f88960996448c498046d63c07ddac3.jpg/v1/crop/x_912,y_0,w_3648,h_3648/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Plant%20Box.jpg)
Tele-Mental Health Consent Form
![Almond Tree Flowers](https://static.wixstatic.com/media/f71c07739c7c4e60aca691acd5abcf68.jpg/v1/crop/x_438,y_0,w_1050,h_1050/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Almond%20Tree%20Flowers.jpg)
Practice Policies & Procedures
![Fern leaf](https://static.wixstatic.com/media/434e60e3934c4b5c9537bdd99977d15a.jpg/v1/crop/x_960,y_0,w_3840,h_3840/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Fern%20leaf.jpg)
No Surprises Act & Good Faith Estimate
![Flowers](https://static.wixstatic.com/media/9f85881a0b6b4b14adf900677681edf1.jpg/v1/crop/x_850,y_0,w_3400,h_3400/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Flowers.jpg)
Notice of Privacy Practices (HIPAA)
![Surreal Glass Flowers](https://static.wixstatic.com/media/11062b_b7bfaa0850254550b3c23c2ccc4a28f9~mv2.jpg/v1/crop/x_640,y_0,w_1632,h_1632/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Surreal%20Glass%20Flowers.jpg)
Patient Intake Form
![Purple and Yellow Pansies](https://static.wixstatic.com/media/74aed89994298ba5b8c996b5d83cbbe6.jpg/v1/crop/x_150,y_0,w_600,h_600/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Purple%20and%20Yellow%20Pansies%20.jpg)
Agreement to Receive Electronic Communications
![Butterfly](https://static.wixstatic.com/media/7cc6b0344c9440818bad598dd590ed27.jpg/v1/crop/x_944,y_0,w_3777,h_3777/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Butterfly.jpg)
Counseling Informed Consent Form
![Pampas Grass](https://static.wixstatic.com/media/11062b_c39434af7e0c46639ffe9d05540abbbb~mv2.jpg/v1/crop/x_0,y_601,w_2404,h_2404/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Pampas%20Grass.jpg)
Release of Information Form
![Blossom](https://static.wixstatic.com/media/a0584e7a0428ae1f0ea1c3d9b29b2978.jpg/v1/crop/x_150,y_0,w_600,h_600/fill/w_190,h_190,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/Blossom%20.jpg)
Couples Counseling Intake Form
bottom of page