Forms

Forms related to our work together are available below.  Please complete the intake form (which is a fillable PDF) and email it to me prior to our first meeting. Because I am currently operating via telehealth due to COVID-19, please also sign and return the Telepsychology Consent Form.  Also please read the Outpatient Services Contract and ask me any questions you may have about it when we meet.  Please also read the Notice of Privacy Practices which describes how your privacy is managed under HIPAA (Health Insurance Privacy and Portability Act of 1996).  Print and sign the Child/Adolescent Contract if you are bringing in your child under age 18.