Helpful Forms

If you're a first-time client, please complete the following forms and bring them to your first session:

• Adolescent Intake Form
• Adult Intake Form

• Permission to Contact PCP
• Notice of Confidentiality and Privacy
• Authorization to File Insurance; Missed Appointment Policy
• Billing and Insurance Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form.
You do not need this form for the first session unless you need me to coordinate care with a doctor other than your primary care physician.

• Policy Consent to Release Information

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