Forms

To fill out intake forms and schedule an appointment click on the web address below:

https://www.therapyportal.com/...

Please print and  complete the following forms and bring them to your first therapy session if unable to connect with the above therapyportal.

Client Psychotherapy Intake Form

• Limits of Confidentiality/Therapy Cancellation Policy

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

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