Forms

Please print, fill out, sign, and initial these forms where indicated and bring them to your first appointment. If you do not have access to a printer, please let me know. Plan to arrive 10 minutes early for your first appointment to allow time to complete them, and I’ll have them in the waiting room for you.

Intake FormDownload
Disclosure and Practice Policies FormDownload
Consent for Transmission of Protected Health Information by Non-secure MeansDownload
Authorization for the Release of InformationDownload