Required Forms Directory

Required forms and information are organized and listed below by client type, adult (those over 18) or children/minors (those age 17 or younger.)

Adult clients (ages 18+) must complete and bring the following forms to our first appointment. Please note that the Notice of Privacy Practices and Psychologists’ Policies is provided for your information and is not required at our appointment.

Forms are available as PDF files and are accessible below or to the right, from our menus.

If you would like to download all ten (10) documents in a zipped folder, rather than doing so individually, you may do so here:

Download Adult Forms Package (.zip)
Children and teen clients (ages 17 and under) must have a parent or legal guardian complete and bring the following forms to the our first appointment. Please note that the Notice of Privacy Practices and Psychologists’ Policies is provided for your information and is not required at our appointment.

By selecting a form with your mouse from the list below, you may view a larger image of the document and download it to your personal computer. All forms are provided as PDF files.

If you would like to download all eleven (11) documents in a zipped folder, rather than doing so individually, you may do so here:

Download Child/Teen Forms Package (.zip)

 

PDF Reader Required

In order to open and read these files once downloaded to your personal computer, your PC or MAC must be equipped with Adobe® PDF Reader or a similar software. Most modern computers are equipped with such a reader, but Adobe provides one free at its site should you need or want one:  Adobe® PDF Reader

 

Your First Appointment

Please print, fill out, and bring the forms with you to your first appointment. If you do not wish me to have contact with your physician or your child’s pediatrician, do not complete those forms, and we can talk about this when we meet.

You do not need to bring the Notice of Privacy Practices and Psychologists’ Policies form with you—this form is for your reference only.

If you do not want to download these forms, or you are not able to do so, the forms will be available for you to complete in my office. You will need to come 20 minutes early to your first appointment to fill them out before we meet.


Contact Your Insurance Company

Before you schedule an appointment, I recommend that you call your insurance company to check your mental health benefits. Your insurance company can tell you what benefits you have, as well as whether or not your benefits are in-network or out-of-network. Please see the Using Insurance page on the website for further information on using insurance, as well as a list of the insurance plans for which I am an in-network provider. You are, of course, welcome to self-pay for therapy.