Forms

Therapy Forms
  • New Client Form

  • Client Contract - Therapy

  • Confidentiality Agreement - Treatment

  • Release of Information -  If you would like me to speak to another person regarding your case this form must be completed and signed. People with whom you want me to be in contact may include anyone ranging from another treatment provider, to an attorney, to a close family member. Should I be contacted by someone regarding your case for whom I do not have this authorization, my commitment to confidentiality remains completely in tact and I will not even acknowledge whether or not you are in treatment with me.

Assessment Forms

  • New Client Form - Assessment

  • Client Contract - Assessment

  • Confidentiality Agreement - Assessment

  • Release of Information -  If you would like me to speak to another person regarding your case this form must be completed and signed. People with whom you want me to be in contact may include anyone ranging from another treatment provider, to an attorney, to a close family member. Should I be contacted by someone regarding your case for whom I do not have this authorization, my commitment to confidentiality remains completely in tact and I will not even acknowledge whether or not you are in treatment with me.

Resources