Patient Forms
Everything you need to get started before your first session
Before Your First Session
These forms help me understand your background, goals, and how I can best support you. Please complete the required forms before we meet—you can download them, fill them out digitally or by hand, and return them via email, text, or in person.
You can also submit forms securely through the patient portal.
Required Forms
Notice of Privacy Practices
HIPAA privacy information and your rights regarding your health information.
Download PDFReceipt of Privacy Practices
Acknowledgment of receipt of privacy notice and treatment policies.
Download PDFAdditional Forms (as needed)
Release of Information
Authorization to share your records with other providers or individuals.
Download PDFEMDR Consent Form
Specific informed consent for Eye Movement Desensitization and Reprocessing therapy.
Download PDFInventory of Preferences
Document your treatment preferences, goals, and therapeutic interests.
Download PDFSubmit Your Completed Forms
Questions About the Forms?
Don't hesitate to reach out if you have any questions about completing these documents or about the intake process.
Contact Me