Counseling Forms


Please read, print, fill out and bring the following forms to your first appointment:

  1. Disclosure Statement (bring signed last page only, p.4)
  2. Patient General Information Form
  3. Email Billing Statements & Appointment Reminders Form
  4. Notice of Privacy Practices (bring signed last page only, p. 7)

I will also have copies of these forms available at our first appointment.



I have posted the following policies as required by HIPAA on this website:

  1. Notice of Privacy Policy related to your Protected Health Information.
  2. Communications Policy

I will also have copies of these policies available at our first appointment.



Please let me know if you have any questions about the HIPAA polices or the forms.  We will review them at our first appointment.  If you are able to take care of the paperwork before your session, we will have more time to focus on your therapy.


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