For your convenience, before our first session, please read, print out, and complete the New Client Registration Form and Agreement for Psychological Services. The Agreement explains my fees, insurance billing, etc.. (Please note that I am an “out of network provider” for insurance plans. Also, remember that you can use your Health Savings or Flexible Savings Account, if applicable.) If you would like me to consult with another professional regarding your care (psychiatrist, primary care physician, another therapist, etc.), please print and complete the Authorization for Release of Information. You may also wish to print and complete the Authorization for Credit Card Payment of Fees if you plan to use your credit card for payment.
Please bring these forms with you to your appointment. At that time we can also address any questions you may have.
All forms are PDF Format. (Get the free Adobe Reader.)