Appointment Request - Helpful Forms

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HELPFUL FORMS FOR YOUR FIRST APPOINTMENT

To schedule an individual, children, couples, marriage or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below or give me a call. To schedule an individual, couples, child, or family therapy appointment, please fill out the forms below or give us a call.     

If you're a new client, please complete the following forms and bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:


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We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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