Patient Forms

Forms and information for new and current patients.

Before Your Appointment

Please download, complete, and bring all required patient forms to your appointment.

Submitting Completed Forms

Do not send completed forms or sensitive medical information through the standard website contact form unless my office has provided specific instructions.

Download Patient Forms

”Before your appointment, please make sure all forms are completed either online or by bringing a filled-out physical copy with you.”

New Patient Registration Form

Patient, contact, insurance, referral, and emergency contact information.

Appointment and Billing Communication Directive

Instructions regarding appointment and billing communications.

Authorization to Disclose Protected Health Information

Authorization to release protected health information to a designated person or organization.

Fee Schedule

Current standard fees for psychotherapy and related services.

Office Policies

Information about appointments, cancellations, payment, insurance, confidentiality, and patient rights.