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Senior Citizen Couple
Senior Citizen Couple

Helpful Forms

If you're a new client, please read, review, and sign these forms and bring them to your first therapy session:

If you would like us to coordinate your care with another provider (i.e., your psychiatrist, primary care physician, attorney) complete this form to authorize release of psychotherapy information:

If you would like to receive a copy of your patient file, complete this form and submit the required payment:

If you are establishing supervised visitation, please complete this intake packet and bring to your individual session:

If you would like your co-payments and services to be billed to a credit card, you must complete the following authorization for billing:

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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