Counseling Services

Individual
Couples & Family
Relationship Issues
Grief and Loss
Anxiety and Fears
Depression
Personal Growth
Parenting Support
Stress Management
African American Mother with Daughter
African American Boy

Helpful Forms

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

  • Client Psychotherapy Intake Form
  • Informed Consent

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:

  • Authorization to Disclose Information Form
If you would like me to coordinate a mutual exchange of information with another provider, complete this form:
  • Exchange Information Consent Form


Adult Psychotherapy Intake Form


 

Child Psychotherapy Intake Form
 
 
Contract for Psychotherapeutic Services
 

Fees, Billing & Insurance Information 
 

Authorization to Disclose Information Form
 

Exchange Information Consent Form
 


Note: To download Adobe Acrobat Reader for free, click here.


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Helpful Forms

Click here to view and print forms for your appointment.

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