If you're a new client, please complete the following forms and bring them to your first therapy session.
- Disclosure Form
- HIPAA Notice of Privacy Practices
- Signature for HIPAA and Disclosure
- Financial Agreement
- Appointment Reminders Form
- Adult Intake Form
- Child Intake Form
- Family Intake Form
- Release of Information
Washington State Law
If you're child is 13+ years old, I will need the child's permission to speak with parents in regard to care, as mandated by the state of Washington. Also, if you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
- Release of information form
Note: To download Adobe Acrobat Reader for free, click here.