Intake Information

Prior to your first session, I ask that you fill out some intake paperwork. If you are unable to fill out this information prior to your arrival, they will be made available to you at the reception desk.

• Notice of Privacy Practices

• Disclosure Statement

• Registration and Intake Form

• Symptom Checklist

• Credit Card Authorization

Additional Forms

Additional forms may be needed throughout your treatment to ensure collaborative and comprehensive care. These forms may be requested prior to, during or following a treatment session but are not generally needed during your  intake appointment. 

• Release of Protected Health Information (PHI)