Patient Forms
Everything you need to get started before your first session
Before Your Consultation or First Session
Choose the section that matches where you are in the process. You may download a complete packet or individual forms as needed. Each PDF can be completed digitally or printed and filled out by hand. When finished, securely upload your completed PDFs below or bring printed copies to an in-person session.
Consultation Packet
Before Our Consultation
Please complete the required consultation forms before we meet. The Inventory of Preferences is optional at this stage.
If you have questions about any form, please contact me before your appointment or we can review them together at the beginning of the consultation.
- Client Intake
- Consent to Treat
- Emergency & Other Contacts
- Inventory of Preferences (optional)
Download individual consultation forms
New Patient Packet
New Patients
If we decide to work together, please complete the additional forms needed before treatment begins. If you already submitted a form during the consultation process and the information is still current, you do not need to complete it again.
The Release of Information is completed when coordination with another healthcare provider or authorized person is needed.
- Notice of Privacy Practices
- Receipt of Privacy Practices
- Emergency & Other Contacts
- AI-Assisted & Digital Technology Consent
- Payment Method Authorization
- Inventory of Preferences
- Release of Information (as needed)
Updates & Renewals Packet
Patient Updates & Renewals
This packet is for current and returning patients. Use it when information has changed, a form needs to be renewed, or a new form is required for your care.
You may not need to complete every form in the packet. We will discuss any required updates or renewals together.
- Client Intake
- Emergency & Other Contacts
- AI-Assisted & Digital Technology Consent
- Payment Method Authorization
- Inventory of Preferences
- Release of Information
Download individual update and renewal forms
Additional Forms
These forms are used only when they apply to your care. We will review any relevant form together beforehand.
Ketamine Preparation & Integration Psychotherapy
Informed Consent and Treatment Roadmap.
Download PDFSubmit Your Completed Forms
Upload your completed PDF forms below. Your files are sent securely to my HIPAA-configured Google Workspace Drive, and you will receive an on-screen confirmation when the upload is complete.
Questions About the Forms?
If you have any questions or need assistance, I'm happy to help.
Contact Me