Forms and Paperwork
For New Clients
Before your first appointment with me I will ask you to review and fill out some paperwork. Please select from the following:
- Adult Client Questionnaire and Informed Consent
- Adolescent Client Questionnaire and Informed Consent
- Couples Client Questionnaire and Informed Consent
- Insurance Verification Form (if you would like me to bill your insurance for your therapy, please return this form at least 5 days in advance of our first scheduled meeting)
The forms are Adobe PDFs and you may download the free reader from Adobe to open the documents. If you prefer, you may contact me and I will mail the forms to you. You may fax them back to me at 888-971-3991 or bring them with you to our first session (exceptions where noted). I treat the information you provide—in writing, in person, in voice-mail and in email messages—as strictly confidential. But please recall that email is not a secure method of communication, so I encourage you to be circumspect in what you send me through that medium.
I may ask you for additional forms during the course of therapy, either for the purpose of enhancing your therapy, for coordinating care with another provider, or for records keeping.
- Release of Information
- Sleep Log
- Contact Information Change/Update